Healthcare Provider Details

I. General information

NPI: 1144194499
Provider Name (Legal Business Name): BLANCA OLGA ESPINOZA DURAND DH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 10/24/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 S CONGRESS AVE STE 101
PALM SPRINGS FL
33461-4746
US

IV. Provider business mailing address

362 LAKE MONTEREY CIR
BOYNTON BEACH FL
33426-8444
US

V. Phone/Fax

Practice location:
  • Phone: 561-642-1000
  • Fax:
Mailing address:
  • Phone: 561-810-9029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH32609
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: