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General NPI Number Information
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NPI Number | 1255964052
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Entity Type | Individual
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Provider Name | CAROL C ESPANA ACOSTA LMT
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Gender | Female
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 3408 W 84TH ST STE 309
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4944
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Country | US
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Telephone | 954-765-6505
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Fax | 954-861-4522
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Provider Business Mailing Address
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Address Line | 3408 W 84TH ST STE 309
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4944
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Country | US
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Telephone | 954-765-6505
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA92012
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License Number State | FL
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