Provider Demographics
NPI:1972382257
Name:ESPINAL, NATHALIE VANESSA (CC)
Entity type:Individual
Prefix:
First Name:NATHALIE
Middle Name:VANESSA
Last Name:ESPINAL
Suffix:
Gender:F
Credentials:CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 WILLOW BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7456
Mailing Address - Country:US
Mailing Address - Phone:407-271-3377
Mailing Address - Fax:
Practice Address - Street 1:3140 WATERMAN WAY
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-5252
Practice Address - Country:US
Practice Address - Phone:352-253-3892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist