MEDICARE: DR. NESTOR L. OLIVO-CRESPO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	012474	PR

General Provider Information

NPI Number	:	1285619775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NESTOR L. OLIVO-CRESPO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 651
Second Line	:
City	:	VEGA ALTA
State	:	PR
Zip	:	00692-0651
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 AVE AMERICO MIRANDA
Second Line	:	REPARTO METROPOLITANO
City	:	SAN JUAN
State	:	PR
Zip	:	00921-1619
Country	:	US
Telephone Number	:	787-781-7295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	02/12/2015

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