Provider Demographics
NPI:1982176798
Name:ESPINOSA, CARHEN S (RD, LDN)
Entity Type:Individual
Prefix:
First Name:CARHEN
Middle Name:S
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10795 NW 50TH ST APT 303
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3972
Mailing Address - Country:US
Mailing Address - Phone:786-357-6808
Mailing Address - Fax:
Practice Address - Street 1:10795 NW 50TH ST APT 303
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3972
Practice Address - Country:US
Practice Address - Phone:786-357-6808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9013133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered