MEDICARE: DR. RONALD RAFAEL ESPINAL M.D.

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	2080P0006X	Developmental - Behavioral Pediatrics Physician	036101123	IL
2	2080P0006X	Developmental - Behavioral Pediatrics Physician	37494	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215921226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD RAFAEL ESPINAL M.D.

Provider Business Mailing Address
First Line	:	920 MADISON AVE SUITE 939
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-4607
Country	:	US
Telephone Number	:	901-287-7337
Fax Number	:	901-287-6804

Provider Business Practice Location Address
First Line	:	51 N DUNLAP ST STE 400
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38105-4625
Country	:	US
Telephone Number	:	901-287-7337
Fax Number	:	901-287-5506

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

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	08/18/2021

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