MEDICARE: OSCAR 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	247100000X	Radiologic Technologist	11391	PR

General Provider Information

NPI Number	:	1477552255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSCAR CRESPO MD

Provider Business Mailing Address
First Line	:	AVE FERNANDEZ JUNCOS 1501 ESQ PAVIA
Second Line	:	EDIF BETANCOURT SUITE 101
City	:	SAN JUAN
State	:	PR
Zip	:	00910
Country	:	US
Telephone Number	:	787-268-6736
Fax Number	:	787-727-4045

Provider Business Practice Location Address
First Line	:	AVE FERNANDEZ JUNCOS CALLE EUROPA
Second Line	:	EDIF BETANCOURT 1501 SUITE 101
City	:	SAN JUAN
State	:	PR
Zip	:	00910
Country	:	US
Telephone Number	:	787-268-6736
Fax Number	:	787-727-4045

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	02/23/2009

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