Healthcare Provider Details

I. General information

NPI: 1124568126
Provider Name (Legal Business Name): PABLO ESPINAL GARCIA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2017
Last Update Date: 02/28/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13559 NARCOOSSEE RD
ORLANDO FL
32832
US

IV. Provider business mailing address

12472 LAKE UNDERHILL RD
ORLANDO FL
32828-7144
US

V. Phone/Fax

Practice location:
  • Phone: 646-339-0629
  • Fax:
Mailing address:
  • Phone: 646-339-0629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN24459
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: