=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518154483
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRANCIS N CRESPO MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2007
-----------------------------------------------------
Last Update Date | 07/25/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1321 NW 14TH STREET SUITE 400
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33125-1673
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-326-3343
-----------------------------------------------------
Fax | 305-325-0887
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15476 NW 77 COURT PMB 423
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-326-3343
-----------------------------------------------------
Fax | 305-325-0887
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. FRANCIS N CRESPO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 305-326-3343
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | ME63638
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------