MEDICARE: NICO ESPINAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	4301517077	MI

General Provider Information

NPI Number	:	1073216958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICO ESPINAL

Provider Business Mailing Address
First Line	:	44344 DEQUINDRE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48314-1038
Country	:	US
Telephone Number	:	586-323-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	44344 DEQUINDRE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48314-1038
Country	:	US
Telephone Number	:	586-323-6300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2023
Last Update Date	:	06/15/2026

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44344 DEQUINDRE RD , STE 510
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Directions to “ NICO ESPINAL ” Practice Location

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