Healthcare Provider Details

I. General information

NPI: 1932405305
Provider Name (Legal Business Name): MISS YELINA ESPINOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2011
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11491 NW 2ND ST APT 110
MIAMI FL
33172-4956
US

IV. Provider business mailing address

11491 NW 2 ST APT 110
MIAMI FL
33172
US

V. Phone/Fax

Practice location:
  • Phone: 305-397-3258
  • Fax:
Mailing address:
  • Phone: 305-397-3258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number60695
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: