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General NPI Number Information
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NPI Number | 1598934143
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Entity Type | Organization
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Legal Business Name | ISRAEL CRESPO MD PA
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 6919 N DALE MABRY HWY SUITE 320
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City | TAMPA
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State | FL
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Zip | 33614-3972
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Country | US
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Telephone | 813-930-8816
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Fax | 813-932-1856
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Provider Business Mailing Address
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Address Line | 6919 N DALE MABRY HWY STE 250
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City | TAMPA
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State | FL
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Zip | 33614-3860
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Country | US
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Telephone | 813-930-8816
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Fax | 813-932-1856
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Authorized Official
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Title or Position | MANAGER
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Name | YOLANDA ROSARIO
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Credential |
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Telephone | 813-997-0071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME67924
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License Number State | FL
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