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General NPI Number Information
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NPI Number | 1003132192
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Entity Type | Individual
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Provider Name | SARA E MENDOZA CRESPO MD
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Gender | Female
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 841 PRUDENTIAL DR STE 280
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8350
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Country | US
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Telephone | 904-202-8290
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Fax | 904-697-2062
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Provider Business Mailing Address
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Address Line | 841 PRUDENTIAL DR STE 280
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8350
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Country | US
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Telephone | 737-256-0807
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Fax | 904-697-2062
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 46861
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | LT000692
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 176277
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License Number State | FL
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