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General NPI Number Information
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NPI Number | 1659334407
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Entity Type | Individual
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Provider Name | MAXIMILIEN RODOLFO ESPINAL MD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 02/10/2011
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Provider Practice Location Address
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Address Line | 537 E ALLEGHENY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-2328
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Country | US
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Telephone | 215-291-9500
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Fax | 215-291-1880
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Provider Business Mailing Address
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Address Line | 224 W MENTOR ST
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City | PHILADELPHIA
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State | PA
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Zip | 19120-4115
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Country | US
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Telephone | 267-444-6658
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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 | 146D00000X
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Taxonomy Name | Personal Emergency Response Attendant
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License Number | 15414
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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