Healthcare Provider Details

I. General information

NPI: 1841053832
Provider Name (Legal Business Name): CARLOS CRESPO-BORGES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OTOLARYNGOLOGY HEAD & NECK SURGERY SECTION UNIVERSITY OF PUERTO RICO, MEDICAL SCIENCES CAMPUS
SAN JUAN PR
00921
US

IV. Provider business mailing address

PO BOX 365067 OTOLARYNGOLOGY SECTION UPR MEDICAL SCIENCES CAMPUS
SAN JUAN PR
00936-5067
US

V. Phone/Fax

Practice location:
  • Phone: 787-765-0240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: