Provider Demographics
NPI:1255124632
Name:ESPINOSA VARELA, JOSE
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:ESPINOSA VARELA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4314 STATE DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6447
Mailing Address - Country:US
Mailing Address - Phone:561-788-1197
Mailing Address - Fax:
Practice Address - Street 1:4314 STATE DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6447
Practice Address - Country:US
Practice Address - Phone:561-788-1197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLE628028429000106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician