Healthcare Provider Details

I. General information

NPI: 1912339953
Provider Name (Legal Business Name): OCTAVIO JOSE ESPINOZA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2013
Last Update Date: 12/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 SW 8TH ST STE 222
MIAMI FL
33144-4002
US

IV. Provider business mailing address

8500 SW 8TH ST STE 222
MIAMI FL
33144-4002
US

V. Phone/Fax

Practice location:
  • Phone: 786-558-8075
  • Fax: 786-558-8076
Mailing address:
  • Phone: 786-558-8075
  • Fax: 786-558-8076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH10947
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: