Healthcare Provider Details

I. General information

NPI: 1760676233
Provider Name (Legal Business Name): JUAN J CESPEDES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JUAN J CESPEDES M.D.

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 08/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 BISCAYNE BLVD
MIAMI FL
33138-4621
US

IV. Provider business mailing address

14005 SW 10TH ST
MIAMI FL
33184-3056
US

V. Phone/Fax

Practice location:
  • Phone: 305-759-4778
  • Fax: 305-756-3502
Mailing address:
  • Phone: 305-979-6632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN 277
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberACN 277
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number16851
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: