Provider Demographics
NPI:1275777633
Name:MIGUEL A ESPINAL PHD
Entity Type:Organization
Organization Name:MIGUEL A ESPINAL PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:ESPINAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-721-9566
Mailing Address - Street 1:1475 WILLOW BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7456
Mailing Address - Country:US
Mailing Address - Phone:917-721-9566
Mailing Address - Fax:
Practice Address - Street 1:1475 WILLOW BRANCH DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7456
Practice Address - Country:US
Practice Address - Phone:917-721-9566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2009-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7285103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty