Provider Demographics
NPI:1376083600
Name:ESPADA, IRAIDA (MS)
Entity Type:Individual
Prefix:
First Name:IRAIDA
Middle Name:
Last Name:ESPADA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 S PALM AVE
Mailing Address - Street 2:
Mailing Address - City:HOWEY IN THE HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34737-3904
Mailing Address - Country:US
Mailing Address - Phone:321-947-6872
Mailing Address - Fax:
Practice Address - Street 1:512 S PALM AVE
Practice Address - Street 2:
Practice Address - City:HOWEY IN THE HILLS
Practice Address - State:FL
Practice Address - Zip Code:34737-3904
Practice Address - Country:US
Practice Address - Phone:321-947-6872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist