Provider Demographics
NPI:1588719454
Name:ESPINO, ESMERALDA CRUZ (MD)
Entity type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:CRUZ
Last Name:ESPINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ESMERALDA
Other - Middle Name:CRUZ
Other - Last Name:ESPINO-TAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:32 GOLDIE RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1973
Mailing Address - Country:US
Mailing Address - Phone:330-759-2679
Mailing Address - Fax:330-759-2857
Practice Address - Street 1:32 GOLDIE RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1973
Practice Address - Country:US
Practice Address - Phone:330-759-2679
Practice Address - Fax:330-759-2857
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2025-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-056474207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110035586OtherMEDICARE RAILROAD
OH0768763Medicaid
ES0667561Medicare ID - Type Unspecified
110035586OtherMEDICARE RAILROAD