Provider Demographics
NPI:1831172998
Name:ESPAILLAT, L FRANCISCO (MD)
Entity type:Individual
Prefix:
First Name:L
Middle Name:FRANCISCO
Last Name:ESPAILLAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LUIS
Other - Middle Name:FRANCISCO
Other - Last Name:ESPAILLAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:3300 US 27 S
Practice Address - Street 2:
Practice Address - City:AVON PARK
Practice Address - State:FL
Practice Address - Zip Code:33825-9701
Practice Address - Country:US
Practice Address - Phone:863-382-6108
Practice Address - Fax:863-382-2182
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37822208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254739OtherAVMED
FLP01639504OtherRR MEDICARE
FL065931200Medicaid
FLQMP000005186688OtherMOLINA
FL28105OtherBCBS
FL1254485OtherWELLCARE
FL020000897OtherRAILROAD MEDICARE
FL4433213OtherCIGNA
FL5632270OtherAETNA
FLP01639504OtherRR MEDICARE
FL28105OtherBCBS
D53482Medicare UPIN