Provider Demographics
NPI:1487701421
Name:ESPINOSA, LEONARDO J
Entity type:Individual
Prefix:DR
First Name:LEONARDO
Middle Name:J
Last Name:ESPINOSA
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 1:913 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3701
Mailing Address - Country:US
Mailing Address - Phone:305-885-7658
Mailing Address - Fax:305-884-3256
Practice Address - Street 1:913 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3701
Practice Address - Country:US
Practice Address - Phone:305-885-7658
Practice Address - Fax:305-884-3256
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN156131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice