Organization
EMERALD MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA LYNN ESPINAL (COO)
(772) 307-9840
Entity
Organization
Contact information
Practice address
6200 20TH ST STE 378, VERO BEACH, FL 32966-1014
(772) 307-9840
(786) 756-8419
Mailing address
2160 58TH AVE # 318, VERO BEACH, FL 32966-4647
(772) 307-9840
(786) 756-8419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN11026541
STATE OF FLORIDA
FL
01
—
HCC14445
STATE OF FLORIDA
FL
01
—
IMH23931
STATE OF FLORIDA
FL
01
—
ME102761
STATE OF FLORIDA LICENSE
FL
01
—
MH17648
STATE OF FLORIDA
FL
01
—
MH22729
STATE OF FLORIDA
FL
01
—
PA9108369
STATE OF FLORIDA
FL
01
—
SW15366
STATE OF FLORIDA
FL
Enumeration date
03/23/2020
Last updated
03/25/2024
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