Healthcare Provider Details
I. General information
NPI: 1184398521
Provider Name (Legal Business Name): DAIRON ESPINOSA MONZON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/08/2021
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
434 SW 12TH AVE STE 100 AND 300
MIAMI FL
33130-2440
US
IV. Provider business mailing address
4719 SW 144TH CT
MIAMI FL
33175-8904
US
V. Phone/Fax
- Phone: 305-266-2929
- Fax: 786-558-0242
- Phone: 786-260-1031
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | 23541 |
| License Number State | PR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | ACN1587 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: