Provider Demographics
NPI:1760676233
Name:CESPEDES, JUAN J (MD)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:J
Last Name:CESPEDES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JUAN
Other - Middle Name:J
Other - Last Name:CESPEDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14005 SW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3056
Mailing Address - Country:US
Mailing Address - Phone:305-979-6632
Mailing Address - Fax:
Practice Address - Street 1:8000 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-4621
Practice Address - Country:US
Practice Address - Phone:305-759-4778
Practice Address - Fax:305-756-3502
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN 277208D00000X, 207K00000X
PR16851208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLACN 277OtherMEDICAL LICENSE
PR16851OtherMEDICAL DOCTOR