MEDICARE: JASMINE NICOLE ESPINOSA

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1477151967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE NICOLE ESPINOSA

Provider Business Mailing Address
First Line	:	120 BROADWAY STE 203
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-5705
Country	:	US
Telephone Number	:	321-206-6560
Fax Number	:

Provider Business Practice Location Address
First Line	:	1176 CYPRESS GLEN CIR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-7560
Country	:	US
Telephone Number	:	407-201-2103
Fax Number	:

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

Provider Enumeration Date	:	10/15/2020
Last Update Date	:	06/01/2026

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Directions to “ JASMINE NICOLE ESPINOSA ” Practice Location

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