Healthcare Provider Details

I. General information

NPI: 1174367080
Provider Name (Legal Business Name): LAURA ESPINOSA ARMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15980 NW 37TH AVE
MIAMI GARDENS FL
33054-6302
US

IV. Provider business mailing address

15980 NW 37TH AVE
MIAMI GARDENS FL
33054-6302
US

V. Phone/Fax

Practice location:
  • Phone: 409-904-4612
  • Fax:
Mailing address:
  • Phone: 409-904-4612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-336482
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: