Provider Demographics
NPI:1740448224
Name:ESPETIA, OSCAR D (MD)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:D
Last Name:ESPETIA
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 1:1613 N. HARRISON PKWY
Mailing Address - Street 2:BLDG C STE 200
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323
Mailing Address - Country:US
Mailing Address - Phone:800-437-2572
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:2501 NORTH PATTERSON STREET
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602
Practice Address - Country:US
Practice Address - Phone:229-333-1000
Practice Address - Fax:229-249-5098
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110364207P00000X
GA065358207P00000X
FLTRN12330390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program