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General NPI Number Information
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NPI Number | 1033251566
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Entity Type | Organization
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Legal Business Name | CARLOS M DE CESPEDES JR,MD.P.A.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3661 S MIAMI AVE 505
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City | MIAMI
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State | FL
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Zip | 33133-4236
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Country | US
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Telephone | 305-556-7809
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Fax | 305-361-1892
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Provider Business Mailing Address
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Address Line | 609 OCEAN DR 11G
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City | KEY BISCAYNE
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State | FL
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Zip | 33149-2326
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Country | US
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Telephone | 305-361-1892
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Fax | 305-361-1892
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. CARLOS MANUEL DE CESPEDES JR.
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Credential | M.D.
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Telephone | 305-556-7809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | ME43009
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License Number State | FL
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