Healthcare Provider Details

I. General information

NPI: 1619886231
Provider Name (Legal Business Name): MADELINE ESPANA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14400 NW 77TH CT STE 100
MIAMI LAKES FL
33016-1590
US

IV. Provider business mailing address

15410 DURNFORD DR
MIAMI LAKES FL
33014-2322
US

V. Phone/Fax

Practice location:
  • Phone: 786-916-6073
  • Fax: 786-657-3092
Mailing address:
  • Phone: 305-794-0350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: