Provider Demographics
NPI:1285768432
Name:LI-ESPINO, EDGARDO E (MD)
Entity type:Individual
Prefix:
First Name:EDGARDO
Middle Name:E
Last Name:LI-ESPINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5147 N 9TH AVE
Mailing Address - Street 2:SUITE 322
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8771
Mailing Address - Country:US
Mailing Address - Phone:850-439-5681
Mailing Address - Fax:850-439-5682
Practice Address - Street 1:5147 N 9TH AVE
Practice Address - Street 2:SUITE 322
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8771
Practice Address - Country:US
Practice Address - Phone:850-439-5681
Practice Address - Fax:850-439-5682
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83674207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
H61980Medicare UPIN
FL12029ZMedicare ID - Type Unspecified
FL264765600Medicaid