Healthcare Provider Details

I. General information

NPI: 1417799073
Provider Name (Legal Business Name): LINDA ALEJANDRA CERNICHIARO ESPINOSA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 DANNY THOMAS PL
MEMPHIS TN
38105-3678
US

IV. Provider business mailing address

19 S MANASSAS ST STE 160
MEMPHIS TN
38103-3308
US

V. Phone/Fax

Practice location:
  • Phone: 866-278-5833
  • Fax:
Mailing address:
  • Phone: 870-771-0015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberNA
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: