MEDICARE: RICARDO ESPAILLAT MD

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	2084P0800X	Psychiatry Physician	ME90593	FL

General Provider Information

NPI Number	:	1700838372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICARDO ESPAILLAT MD

Provider Business Mailing Address
First Line	:	7501 WILES RD
Second Line	:	SUITE 105
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2063
Country	:	US
Telephone Number	:	954-346-8300
Fax Number	:	954-346-8303

Provider Business Practice Location Address
First Line	:	7501 WILES RD
Second Line	:	SUITE 105
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2063
Country	:	US
Telephone Number	:	954-346-8300
Fax Number	:	954-346-8303

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	08/31/2017

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