MEDICARE: DR. JUAN CARLOS ACEVEDO-CRESPO M.D.

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	207RP1001X	Pulmonary Disease Physician	ME63849	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	:	1720074545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN CARLOS ACEVEDO-CRESPO M.D.

Provider Business Mailing Address
First Line	:	8600 SW 92ND ST
Second Line	:	SUITE 204A
City	:	MIAMI
State	:	FL
Zip	:	33156-7397
Country	:	US
Telephone Number	:	305-436-9933
Fax Number	:	305-500-2137

Provider Business Practice Location Address
First Line	:	747 PONCE DE LEON BLVD
Second Line	:	SUITE 500
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2049
Country	:	US
Telephone Number	:	305-648-1119
Fax Number	:	305-648-1129

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

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	07/26/2022

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