Provider Demographics
NPI:1548421894
Name:ESPINAL, CAROL MADLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:MADLYN
Last Name:ESPINAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14075 TOWN LOOP BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-6132
Mailing Address - Country:US
Mailing Address - Phone:407-438-5858
Mailing Address - Fax:407-438-7172
Practice Address - Street 1:14075 TOWN LOOP BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6132
Practice Address - Country:US
Practice Address - Phone:407-438-5858
Practice Address - Fax:407-438-7172
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME113725207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006618200Medicaid
FL006618200Medicaid