Provider Demographics
NPI:1700652344
Name:ESPINAL, QUISQUEYA
Entity Type:Individual
Prefix:MRS
First Name:QUISQUEYA
Middle Name:
Last Name:ESPINAL
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:QUISQUEYA
Other - Middle Name:
Other - Last Name:ESPINAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:16202 SW 61ST LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5829
Mailing Address - Country:US
Mailing Address - Phone:786-271-3460
Mailing Address - Fax:
Practice Address - Street 1:12060 SW 129TH CT STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4582
Practice Address - Country:US
Practice Address - Phone:786-574-3931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029834363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health