Healthcare Provider Details

I. General information

NPI: 1154426955
Provider Name (Legal Business Name): CARMEN L ESPINOSA M. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 SW 88TH STREET STE 280
MIAMI FL
33186
US

IV. Provider business mailing address

13550 SW 88TH STREET STE 280
MIAMI FL
33186
US

V. Phone/Fax

Practice location:
  • Phone: 305-753-7350
  • Fax:
Mailing address:
  • Phone: 305-753-7350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME-0042092
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: