Provider Demographics
NPI:1821223595
Name:ESPINEL, ALFONSO LUIS (MD,)
Entity Type:Individual
Prefix:DR
First Name:ALFONSO
Middle Name:LUIS
Last Name:ESPINEL
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3018 53RD AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-4331
Mailing Address - Country:US
Mailing Address - Phone:941-348-2760
Mailing Address - Fax:941-348-2761
Practice Address - Street 1:3018 53RD AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-4331
Practice Address - Country:US
Practice Address - Phone:941-348-2760
Practice Address - Fax:941-348-2761
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-23
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31516207Q00000X
MS25695207Q00000X
FLME114272207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine