Provider Demographics
NPI:1427474584
Name:ESPENSCHIED, JOHANNA (PA-C)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:ESPENSCHIED
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4624
Mailing Address - Country:US
Mailing Address - Phone:407-481-2620
Mailing Address - Fax:407-992-7700
Practice Address - Street 1:700 E MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4624
Practice Address - Country:US
Practice Address - Phone:407-481-2620
Practice Address - Fax:407-992-7700
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9107538363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical