Provider Demographics
NPI:1801007133
Name:PEREZ-CRESPO, ORLANDO (MA48993)
Entity Type:Individual
Prefix:MR
First Name:ORLANDO
Middle Name:
Last Name:PEREZ-CRESPO
Suffix:
Gender:M
Credentials:MA48993
Other - Prefix:
Other - First Name:FUSION
Other - Middle Name:
Other - Last Name:MASSAGE & FITNESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10209 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7127
Mailing Address - Country:US
Mailing Address - Phone:813-781-4153
Mailing Address - Fax:813-972-0454
Practice Address - Street 1:10209 N 23RD ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7127
Practice Address - Country:US
Practice Address - Phone:813-781-4153
Practice Address - Fax:813-972-0454
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48993225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist