Healthcare Provider Details

I. General information

NPI: 1922926906
Provider Name (Legal Business Name): ZOILO DE JESUS CRESPO ALONSO DMD, DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1379 S NARCOOSSEE RD
SAINT CLOUD FL
34771-7239
US

IV. Provider business mailing address

1379 S NARCOOSSEE RD
SAINT CLOUD FL
34771-7239
US

V. Phone/Fax

Practice location:
  • Phone: 689-336-1559
  • Fax:
Mailing address:
  • Phone: 689-336-1559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401419859
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: