Healthcare Provider Details

I. General information

NPI: 1174488530
Provider Name (Legal Business Name): MELANY SEGARRA CRESPO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3557 SW 90TH TER
MIRAMAR FL
33025-7633
US

IV. Provider business mailing address

3557 SW 90TH TER
MIRAMAR FL
33025-7633
US

V. Phone/Fax

Practice location:
  • Phone: 305-934-1761
  • Fax:
Mailing address:
  • Phone: 305-934-1761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11044272
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: