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General NPI Number Information
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NPI Number | 1952943912
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Entity Type | Organization
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Legal Business Name | EMERGENCY INNOVATIVE SERVICES LLC
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 1804 59TH ST W
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City | BRADENTON
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State | FL
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Zip | 34209-4630
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Country | US
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Telephone | 941-313-5378
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Fax |
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Provider Business Mailing Address
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Address Line | 15121 SUNDIAL PL
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-5902
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Country | US
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Telephone | 941-313-5378
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALFONSO ESPINEL
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Credential | MD
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Telephone | 941-313-5378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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