Healthcare Provider Details

I. General information

NPI: 1326546409
Provider Name (Legal Business Name): KATHERINE ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 ZENITH CIR
FORT MYERS FL
33913-7522
US

IV. Provider business mailing address

113 ZENITH CIR
FORT MYERS FL
33913-7522
US

V. Phone/Fax

Practice location:
  • Phone: 239-362-4785
  • Fax:
Mailing address:
  • Phone: 239-362-4785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-56938
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberBACB432425
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: