Provider Demographics
NPI:1346513876
Name:CARLOS L. ESQUIVIA-MUNOZ, M.D.P.A.
Entity Type:Organization
Organization Name:CARLOS L. ESQUIVIA-MUNOZ, M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:L
Authorized Official - Last Name:ESQUIVIA-MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-272-2525
Mailing Address - Street 1:1895 KINGSLEY AVE
Mailing Address - Street 2:SUITE 701
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4466
Mailing Address - Country:US
Mailing Address - Phone:904-272-2525
Mailing Address - Fax:904-272-2700
Practice Address - Street 1:1895 KINGSLEY AVE
Practice Address - Street 2:SUITE 701
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4466
Practice Address - Country:US
Practice Address - Phone:904-272-2525
Practice Address - Fax:904-272-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0021696207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty