Provider Demographics
NPI:1588745582
Name:ESPINOSA, ANA CECILIA (OTR)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:CECILIA
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 NW 156TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1517
Mailing Address - Country:US
Mailing Address - Phone:305-826-7884
Mailing Address - Fax:305-826-1545
Practice Address - Street 1:5931 NW 173RD DR
Practice Address - Street 2:UNIT 10
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5106
Practice Address - Country:US
Practice Address - Phone:305-826-7884
Practice Address - Fax:305-286-1545
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT5881225X00000X
CO1-14-16123103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017471000Medicaid
FL886019000Medicaid