Provider Demographics
NPI:1851983316
Name:ESPINOZA DE MENDOZA, DECIRE (APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:DECIRE
Middle Name:
Last Name:ESPINOZA DE MENDOZA
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3690 DAVIE BLVD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-3440
Mailing Address - Country:US
Mailing Address - Phone:305-266-2929
Mailing Address - Fax:786-377-5561
Practice Address - Street 1:3690 DAVIE BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-3440
Practice Address - Country:US
Practice Address - Phone:305-266-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011483363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily