Provider Demographics
NPI:1568419687
Name:CRESPIN, JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:CRESPIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 SW 107TH AVE
Mailing Address - Street 2:STE 46/47
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2470
Mailing Address - Country:US
Mailing Address - Phone:305-228-9601
Mailing Address - Fax:305-228-6742
Practice Address - Street 1:2500 SW 107TH AVE
Practice Address - Street 2:STE 46/47
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2470
Practice Address - Country:US
Practice Address - Phone:305-228-9601
Practice Address - Fax:305-228-6742
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60672207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine