Provider Demographics
NPI:1720074545
Name:ACEVEDO-CRESPO, JUAN CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:CARLOS
Last Name:ACEVEDO-CRESPO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8600 SW 92ND ST
Mailing Address - Street 2:SUITE 204A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7397
Mailing Address - Country:US
Mailing Address - Phone:305-436-9933
Mailing Address - Fax:305-500-2137
Practice Address - Street 1:747 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2049
Practice Address - Country:US
Practice Address - Phone:305-648-1119
Practice Address - Fax:305-648-1129
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2022-07-26
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Provider Licenses
StateLicense IDTaxonomies
FLME63849207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377208000Medicaid
FL26631UMedicare PIN
FL377208000Medicaid