Provider Demographics
NPI:1578666467
Name:ESPINOSA, ANAMAGUEL (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANAMAGUEL
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 BRICKELL AVE APT 14A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2421
Mailing Address - Country:US
Mailing Address - Phone:305-859-7487
Mailing Address - Fax:
Practice Address - Street 1:1300 CORAL WAY
Practice Address - Street 2:SUITE 207
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145
Practice Address - Country:US
Practice Address - Phone:305-854-7244
Practice Address - Fax:305-854-0154
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3882235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL885758000Medicaid