Miguel Antonio Espinal Rodriguez, PH.D.
Individual provider Active NPI Clinical Psychologist · Orlando, FL
NPI 1679740930 · NPPES record last updated May 14, 2008
Key facts
- NPI
- 1679740930
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY 7285 (FL)
- Practice address
- 1475 Willow Branch Dr
Orlando, FL 32828-7456 - Phone
- (917) 721-9566
- NPI assigned
- May 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Health Care Center for the Homeless Inc
Ace Behavioral Health LLC
Practice addresses (Care Compare)
232 N Orange Blossom TRL
Orlando, FL 32805-1612
Phone 4074285751329
5406 Hoover Blvd
Suite 18
Tampa, FL 33634-5330
Phone (866) 770-4104
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090805000343 | FL | Practitioner - Clinical Psychologist | 2567515703 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 7285 | FL | MD | Clinical Psychologist |
| 8380 | NY | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ace Behavioral Health LLC | Current |
Accepting new patients | |
| Citrus County Rural Health Inc | Current |
Accepting new patients |
Locations
927 N Citrus Ave
Crystal River, FL 34428
Phone (352) 404-5588
5406 Hoover Blvd
Ste 18
Tampa, FL 33634
Phone (813) 880-7577
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY 7285 | FL | Yes |
Addresses
Primary practice location
1475 Willow Branch Dr
Orlando, FL 32828-7456
Mailing address
1475 Willow Branch Dr
Orlando, FL 32828-7456
Phone (917) 721-9566
Other providers in Orlando, FL
- Esperanza Eye Care Inc.
- Gabrielle Espert
- Biulenyx Espin
- Nestor Luis Espina Reinoza
- Pablo Espinal Garcia
- Carol Madlyn Espinal
- Jerelly Espinal
- Yasser Espinal
- Shakhnoza Espinales
- Helen Espino Rieche
All providers in Orlando, FL · Clinical Psychologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.