Provider Demographics
NPI:1942584248
Name:ESPINOSA, ROBERTO A (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:A
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16335 SW 81ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5102
Mailing Address - Country:US
Mailing Address - Phone:305-609-1242
Mailing Address - Fax:305-591-7402
Practice Address - Street 1:8250 NW 27TH ST
Practice Address - Street 2:SUITE 311
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1904
Practice Address - Country:US
Practice Address - Phone:305-591-1085
Practice Address - Fax:305-591-7402
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist