Healthcare Provider Details

I. General information

NPI: 1598175143
Provider Name (Legal Business Name): JOSEPH RAYMOND ESPARAZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 240
ORLANDO FL
32804-4641
US

IV. Provider business mailing address

2501 N ORANGE AVE STE 240
ORLANDO FL
32804-4641
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-7280
  • Fax:
Mailing address:
  • Phone: 407-303-7280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number38267
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberME166361
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: