Provider Demographics
NPI:1932514833
Name:LIRIANO ESPINAL, LARRY GUILLERMO (MD)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:GUILLERMO
Last Name:LIRIANO ESPINAL
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 1:8305 HAMMOCKS BLVD APT 5111
Mailing Address - Street 2:APT 5111
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-4170
Mailing Address - Country:US
Mailing Address - Phone:787-478-5618
Mailing Address - Fax:
Practice Address - Street 1:700 SE 5TH TER STE 2
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-4865
Practice Address - Country:US
Practice Address - Phone:787-478-5618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-30
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME140713207R00000X, 207RE0101X, 207R00000X, 207RE0101X
PR32337390200000X
CODR.00603172084N0400X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL38OWOtherFLORIDA BLUE
FL103658000Medicaid