MEDICARE: DR. LUIS ARIEL CRESPO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	ME168250	FL
2	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	ME168250	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265069967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS ARIEL CRESPO MD

Provider Business Mailing Address
First Line	:	3004 W NEPTUNE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-6048
Country	:	US
Telephone Number	:	813-245-0663
Fax Number	:

Provider Business Practice Location Address
First Line	:	5041 W CYPRESS ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-3803
Country	:	US
Telephone Number	:	813-245-0663
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2020
Last Update Date	:	07/28/2025

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