Healthcare Provider Details

I. General information

NPI: 1811474240
Provider Name (Legal Business Name): EUGENIO ESPINOSA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 07/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 NW 45TH AVE
MIAMI FL
33126-5341
US

IV. Provider business mailing address

75 NW 45TH AVE
MIAMI FL
33126-5341
US

V. Phone/Fax

Practice location:
  • Phone: 305-807-9227
  • Fax:
Mailing address:
  • Phone: 305-807-9227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9428529
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: