Healthcare Provider Details

I. General information

NPI: 1760339659
Provider Name (Legal Business Name): CRESPOMEDCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 E 25TH ST STE 320
HIALEAH FL
33013-3849
US

IV. Provider business mailing address

777 E 25TH ST STE 320
HIALEAH FL
33013-3849
US

V. Phone/Fax

Practice location:
  • Phone: 305-302-0380
  • Fax:
Mailing address:
  • Phone: 305-302-0380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: RAFAEL CRESPO FERNANDEZ
Title or Position: MD
Credential: MD
Phone: 305-302-0380