Healthcare Provider Details

I. General information

NPI: 1831038454
Provider Name (Legal Business Name): LIVAN ESPINOSA HURTADO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5916 MCKINLEY ST
HOLLYWOOD FL
33021-4561
US

IV. Provider business mailing address

5916 MCKINLEY ST
HOLLYWOOD FL
33021-4561
US

V. Phone/Fax

Practice location:
  • Phone: 786-759-7212
  • Fax:
Mailing address:
  • Phone: 786-759-7212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI8649
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: