Basic Information
| Provider Information | |||||||||
| NPI: | 1255513214 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESPAILLAT PRESTOL | ||||||||
| FirstName: | DIEGO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21097 NE 27TH CT | ||||||||
| Address2: | STE 540 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034602713 | ||||||||
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| Practice Location | |||||||||
| Address1: | 21097 NE 27TH CT | ||||||||
| Address2: | SUITE 540 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7866232000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2007 | ||||||||
| LastUpdateDate: | 01/27/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | ME128770 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207R00000X | ME128770 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.