Healthcare Provider Details

I. General information

NPI: 1447750104
Provider Name (Legal Business Name): MASSIEL ESPINOSA-GARRIGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11042 SW 241ST ST
HOMESTEAD FL
33032-5138
US

IV. Provider business mailing address

11042 SW 241ST ST
HOMESTEAD FL
33032-5138
US

V. Phone/Fax

Practice location:
  • Phone: 786-694-0026
  • Fax:
Mailing address:
  • Phone: 786-694-0026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11035008
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: