Provider Demographics
NPI:1760776736
Name:ESPINOSA-DUQUE, DIANA PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:PATRICIA
Last Name:ESPINOSA-DUQUE
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 1:12871 CITRUS PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-3010
Mailing Address - Country:US
Mailing Address - Phone:813-471-4455
Mailing Address - Fax:813-343-5022
Practice Address - Street 1:12871 CITRUS PLAZA DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3010
Practice Address - Country:US
Practice Address - Phone:813-471-4455
Practice Address - Fax:813-343-5022
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME131068208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020349800Medicaid