Provider Demographics
NPI:1861697948
Name:ESPINOSA, PATRICIO SEBASTIAN (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:PATRICIO
Middle Name:SEBASTIAN
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9960 NW 116TH WAY STE 13
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1175
Mailing Address - Country:US
Mailing Address - Phone:617-640-3484
Mailing Address - Fax:786-924-1313
Practice Address - Street 1:2900 N MILITARY TRL
Practice Address - Street 2:SUITE 110
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6365
Practice Address - Country:US
Practice Address - Phone:617-640-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1150032084N0400X, 204D00000X
KY400102084N0600X
LA2032692084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1802107Medicaid
LA249558YJXFMedicare PIN
LA1802107Medicaid