Healthcare Provider Details

I. General information

NPI: 1013571744
Provider Name (Legal Business Name): ANDREA CAROLINA ESPINOSA BS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2019
Last Update Date: 05/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10550 NW 77TH CT STE 313-314
HIALEAH GARDENS FL
33016-7084
US

IV. Provider business mailing address

8251 NW 8TH ST APT 108
MIAMI FL
33126-3945
US

V. Phone/Fax

Practice location:
  • Phone: 305-825-4320
  • Fax: 305-825-8117
Mailing address:
  • Phone: 786-222-0569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: