Healthcare Provider Details

I. General information

NPI: 1033820840
Provider Name (Legal Business Name): OSCAR ESPINOSA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12651 S DIXIE HWY STE 205
PINECREST FL
33156-5955
US

IV. Provider business mailing address

12651 S DIXIE HWY STE 205
PINECREST FL
33156-5955
US

V. Phone/Fax

Practice location:
  • Phone: 305-232-9222
  • Fax:
Mailing address:
  • Phone: 305-232-9222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number39679
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: