Provider Demographics
NPI:1467683771
Name:L FRANCISCO ESPAILLAT MD PA
Entity Type:Organization
Organization Name:L FRANCISCO ESPAILLAT MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:ESPAILLAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-382-6108
Mailing Address - Street 1:723 US 27 S
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-2169
Mailing Address - Country:US
Mailing Address - Phone:863-382-6108
Mailing Address - Fax:863-382-2182
Practice Address - Street 1:723 US 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-2169
Practice Address - Country:US
Practice Address - Phone:863-382-6108
Practice Address - Fax:863-382-2182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37822208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL065931200Medicaid
FL281058Medicare PIN
FLD53482Medicare UPIN