Healthcare Provider Details

I. General information

NPI: 1922024421
Provider Name (Legal Business Name): TRINA ELENA ESPINOLA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 6TH AVE S SUITE 385
ST PETERSBURG FL
33701-4662
US

IV. Provider business mailing address

PO BOX 13247
ST PETERSBURG FL
33733-3247
US

V. Phone/Fax

Practice location:
  • Phone: 727-553-7100
  • Fax:
Mailing address:
  • Phone: 727-553-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberME0064176
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number019320
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME64176
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: