Healthcare Provider Details

I. General information

NPI: 1447811450
Provider Name (Legal Business Name): ADAN ESPINOZA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 06/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20325 OLD CUTLER RD
CUTLER BAY FL
33189-1831
US

IV. Provider business mailing address

13709 SW 154TH ST
MIAMI FL
33177-8123
US

V. Phone/Fax

Practice location:
  • Phone: 305-812-0188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: