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General NPI Number Information
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NPI Number | 1750542395
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Entity Type | Individual
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Provider Name | OCTAVIANO ESPINOSA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1333 TAYLOR ST STE 2D
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City | COLUMBIA
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State | SC
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Zip | 29201-2945
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Country | US
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Telephone | 803-753-7524
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Fax |
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Provider Business Mailing Address
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Address Line | 460 CLEMSON RD
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City | COLUMBIA
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State | SC
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Zip | 29229-7925
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Country | US
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Telephone | 803-438-3800
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME156854
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 93649
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101246077
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 70875
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License Number State | TN
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