Healthcare Provider Details

I. General information

NPI: 1316859531
Provider Name (Legal Business Name): SOPHIA ESPINOZA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3410 GATEWAY CENTRE PKWY
PINELLAS PARK FL
33782-6193
US

IV. Provider business mailing address

6207 S WEST SHORE BLVD APT 2035
TAMPA FL
33616-1640
US

V. Phone/Fax

Practice location:
  • Phone: 727-630-2002
  • Fax:
Mailing address:
  • Phone: 719-629-8725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT26507
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: