Healthcare Provider Details

I. General information

NPI: 1750902136
Provider Name (Legal Business Name): MELANIE ESPINET MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2020
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 N PARKWAY FRONTAGE RD
LAKELAND FL
33803-0401
US

IV. Provider business mailing address

1740 OLD FASHIONED WAY APT 2221
OCOEE FL
34761-4277
US

V. Phone/Fax

Practice location:
  • Phone: 863-680-7000
  • Fax: 866-264-8519
Mailing address:
  • Phone: 347-898-9808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME165010
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: