Provider Demographics
NPI:1033251566
Name:CARLOS M DE CESPEDES JR,MD.P.A.
Entity Type:Organization
Organization Name:CARLOS M DE CESPEDES JR,MD.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:DE CESPEDES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:305-556-7809
Mailing Address - Street 1:609 OCEAN DR
Mailing Address - Street 2:11G
Mailing Address - City:KEY BISCAYNE
Mailing Address - State:FL
Mailing Address - Zip Code:33149-2326
Mailing Address - Country:US
Mailing Address - Phone:305-361-1892
Mailing Address - Fax:305-361-1892
Practice Address - Street 1:3661 S MIAMI AVE
Practice Address - Street 2:505
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4236
Practice Address - Country:US
Practice Address - Phone:305-556-7809
Practice Address - Fax:305-361-1892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43009207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79819AMedicare ID - Type Unspecified
FLD58939Medicare UPIN