Healthcare Provider Details

I. General information

NPI: 1912831660
Provider Name (Legal Business Name): ENRIQUE CORUJO ESQUILIN DR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4313 DELEON ST
HAINES CITY FL
33844-6513
US

IV. Provider business mailing address

4313 DELEON ST
HAINES CITY FL
33844-6513
US

V. Phone/Fax

Practice location:
  • Phone: 407-837-6014
  • Fax:
Mailing address:
  • Phone: 407-837-6014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: