Healthcare Provider Details

I. General information

NPI: 1891771812
Provider Name (Legal Business Name): ALEJANDRO ESPAILLAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PALMETTO HEALTH PKWY STE 350
COLUMBIA SC
29212-1756
US

IV. Provider business mailing address

300 E MCBEE AVE STE 300
GREENVILLE SC
29601-2899
US

V. Phone/Fax

Practice location:
  • Phone: 803-907-2020
  • Fax: 803-907-7720
Mailing address:
  • Phone: 864-522-8611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number93961
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME81887
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: