Healthcare Provider Details

I. General information

NPI: 1073231957
Provider Name (Legal Business Name): MAYRA ESPINOSA DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 S LAKEWOOD DR
BRANDON FL
33511-2815
US

IV. Provider business mailing address

313 S LAKEWOOD DR
BRANDON FL
33511-2815
US

V. Phone/Fax

Practice location:
  • Phone: 813-349-7900
  • Fax:
Mailing address:
  • Phone: 813-349-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11020220
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: