Provider Demographics
NPI:1538833017
Name:POINVIL, ESPENITA
Entity type:Individual
Prefix:
First Name:ESPENITA
Middle Name:
Last Name:POINVIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11647 TROPICAL ISLE LN
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7281
Mailing Address - Country:US
Mailing Address - Phone:813-679-8012
Mailing Address - Fax:
Practice Address - Street 1:11647 TROPICAL ISLE LN
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7281
Practice Address - Country:US
Practice Address - Phone:813-679-8012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities