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General NPI Number Information
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NPI Number | 1457720211
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Entity Type | Individual
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Provider Name | MARINA F ESPINOSA
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Gender | Female
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Dates
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Enumeration Date | 09/22/2015
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 4898 E IRLO BRONSON MEMORIAL HWY
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City | SAINT CLOUD
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State | FL
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Zip | 34771-8714
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Country | US
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Telephone | 407-891-1308
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Fax |
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Provider Business Mailing Address
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Address Line | 541 MICHIGAN STATES CL
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City | SAINT CLOUD
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State | FL
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Zip | 34769
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Country | US
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Telephone | 407-346-0573
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Fax | 855-479-5650
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH13204
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License Number State | FL
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