Provider Demographics
NPI:1386185171
Name:DARIO M ESPINA MD PA
Entity Type:Organization
Organization Name:DARIO M ESPINA MD PA
Other - Org Name:PREVENTIVE CARDIOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARIO
Authorized Official - Middle Name:M
Authorized Official - Last Name:ESPINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-646-2229
Mailing Address - Street 1:4200 JENNY LIND RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-7632
Mailing Address - Country:US
Mailing Address - Phone:479-646-2229
Mailing Address - Fax:479-646-1984
Practice Address - Street 1:4200 JENNY LIND RD
Practice Address - Street 2:SUITE G
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-7632
Practice Address - Country:US
Practice Address - Phone:479-646-2229
Practice Address - Fax:479-646-1984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1954207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty