Healthcare Provider Details

I. General information

NPI: 1093840522
Provider Name (Legal Business Name): CLAUDIA MILY ESPINOSA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAUDIA MILY HENAO GUTIERREZ MD

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13330 USF LAUREL DR
TAMPA FL
33612
US

IV. Provider business mailing address

PO BOX 917770
ORLANDO FL
32891-0001
US

V. Phone/Fax

Practice location:
  • Phone: 813-974-2201
  • Fax: 813-974-4325
Mailing address:
  • Phone: 813-974-2201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number4301093992
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number0433582
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number45247
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number45247
License Number StateKY
# 5
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberME141047
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: