Provider Demographics
NPI:1346576493
Name:ESPEJO, SILVIA DAMARIS (MS)
Entity type:Individual
Prefix:MS
First Name:SILVIA
Middle Name:DAMARIS
Last Name:ESPEJO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6833 SW 16TH CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2061
Mailing Address - Country:US
Mailing Address - Phone:954-549-7724
Mailing Address - Fax:
Practice Address - Street 1:6833 SW 16TH CT
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33023-2061
Practice Address - Country:US
Practice Address - Phone:954-549-7724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health
No302F00000XManaged Care OrganizationsExclusive Provider Organization