MEDICARE: AYTSA 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	183500000X	Pharmacist	PS40696	FL

General Provider Information

NPI Number	:	1790381606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYTSA ESPINOSA

Provider Business Mailing Address
First Line	:	13796 SW 152ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-1163
Country	:	US
Telephone Number	:	305-235-4368
Fax Number	:	786-249-0014

Provider Business Practice Location Address
First Line	:	13796 SW 152ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-1163
Country	:	US
Telephone Number	:	305-235-4368
Fax Number	:	786-249-0014

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

Provider Enumeration Date	:	12/07/2020
Last Update Date	:	12/07/2020

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Directions to “ AYTSA ESPINOSA ” Practice Location

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