Provider Demographics
NPI:1932103793
Name:ESPINO & ESPINO, P.A.
Entity Type:Organization
Organization Name:ESPINO & ESPINO, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GONZALO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ESPINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MSA
Authorized Official - Phone:904-387-3124
Mailing Address - Street 1:2315 PARK ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4317
Mailing Address - Country:US
Mailing Address - Phone:904-387-3124
Mailing Address - Fax:
Practice Address - Street 1:2315 PARK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4317
Practice Address - Country:US
Practice Address - Phone:904-387-3124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty