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Organization
ESPAILLAT MEDICAL GROUP PLLC
Active
Organization
ESPAILLAT MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIEGO ESPAILLAT PRESTOL M.D. (OWNER/ PRESIDENT)
(305) 234-8264
Entity
Organization
Contact information
Practice address
12002 SW 128TH CT STE 204, MIAMI, FL 33186-4643
(305) 234-8264
Mailing address
PO BOX 144295, CORAL GABLES, FL 33114-4295
(305) 234-8264
(305) 255-1752
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME128770
MEDICAL LICENSE
FL
Enumeration date
03/16/2020
Last updated
03/16/2020
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