Healthcare Provider Details

I. General information

NPI: 1871497750
Provider Name (Legal Business Name): CARLOS ESPADA APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 DANIELS RD
WINTER GARDEN FL
34787-3835
US

IV. Provider business mailing address

1248 WOODSTOCK DR
APOPKA FL
32703-7321
US

V. Phone/Fax

Practice location:
  • Phone: 689-240-7945
  • Fax:
Mailing address:
  • Phone: 908-574-9031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11051080
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: