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General NPI Number Information
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NPI Number | 1679943823
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Entity Type | Individual
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Provider Name | MARLIZ CRESPO M.S.
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Gender | Female
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 05/29/2018
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Provider Practice Location Address
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Address Line | 425 SW 79TH TER
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068
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Country | US
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Telephone | 954-632-1358
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Fax |
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Provider Business Mailing Address
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Address Line | 11005 NW 39TH ST APT 206
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City | SUNRISE
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State | FL
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Zip | 33351-7559
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Country | US
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Telephone |
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Fax |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA14953
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License Number State | FL
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