Provider Demographics
NPI:1114010998
Name:ESPERANZA, MICHELLE (OD)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:ESPERANZA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:ESPERANZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:1480 CANOPY PASTURE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8886
Mailing Address - Country:US
Mailing Address - Phone:407-799-7281
Mailing Address - Fax:407-870-0747
Practice Address - Street 1:601 E OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4574
Practice Address - Country:US
Practice Address - Phone:407-799-7281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4278152WC0802X, 152W00000X
TNODT2644152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management