Provider Demographics
NPI:1881140937
Name:ESPINOSA, BRAULIO (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRAULIO
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BRAULIO
Other - Middle Name:
Other - Last Name:ESPINOSA SERRANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:5151 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1258
Mailing Address - Country:US
Mailing Address - Phone:786-252-2017
Mailing Address - Fax:
Practice Address - Street 1:5151 SW 4TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1258
Practice Address - Country:US
Practice Address - Phone:786-252-2017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31780225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist