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Individual

PROF. WALDO OSCAR ESPARZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.S., C.P.

Contact information

Practice address
5109 N ARMENIA AVE, TAMPA, FL 33603-1405
(813) 801-9110
(813) 801-9048
Mailing address
5109 N ARMENIA AVE, TAMPA, FL 33603-1405
(813) 801-9110
(813) 801-9048

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
PRO 25
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
290808
STAYWELL
FL
01
7376145
AETNA EPDB PIN #
FL
01
R9100
BLUE CROSS BLUE SHIELD FL
FL
01
V516P-7063
VA VENDOR #
FL
Enumeration date
06/28/2006
Last updated
07/08/2007
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