Provider Demographics
NPI:1093840522
Name:ESPINOSA, CLAUDIA MILY (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:MILY
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:MILY
Other - Last Name:HENAO GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:813-974-2201
Mailing Address - Fax:
Practice Address - Street 1:13330 USF LAUREL DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612
Practice Address - Country:US
Practice Address - Phone:813-974-2201
Practice Address - Fax:813-974-4325
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010939922080P0208X
KS04335822080P0208X
KY45247208000000X, 2080P0208X
FLME1410472080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100210910Medicaid
FLVGPXZOtherBLUE CROSS BLUE SHIELD
IN201175820Medicaid
FL103421700Medicaid
FLLK785OtherMEDICARE