Healthcare Provider Details

I. General information

NPI: 1326747593
Provider Name (Legal Business Name): DANESA CRESPO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 NE 9TH AVE
CAPE CORAL FL
33909-1491
US

IV. Provider business mailing address

1334 NE 9TH AVE
CAPE CORAL FL
33909-1491
US

V. Phone/Fax

Practice location:
  • Phone: 239-400-9177
  • Fax:
Mailing address:
  • Phone: 239-400-9177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2829164
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: