=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932347036
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOSE A ESNARD MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2009
-----------------------------------------------------
Last Update Date | 01/27/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4155 SW 130TH AVE STE 102
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33175-3414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-223-3580
-----------------------------------------------------
Fax | 305-223-3582
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4155 SW 130TH AVE STE 102
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33175-3414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-223-3580
-----------------------------------------------------
Fax | 305-223-3582
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSYCIAN/OWNER
-----------------------------------------------------
Name | DR. JOSE A ESNARD
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 305-223-3580
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number | ME19828
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------