Provider Demographics
NPI:1982896494
Name:VICTOR P. KRESTOW, MD, PA
Entity Type:Organization
Organization Name:VICTOR P. KRESTOW, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:P
Authorized Official - Last Name:KRESTOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-652-3614
Mailing Address - Street 1:7 NW 183RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4516
Mailing Address - Country:US
Mailing Address - Phone:305-652-3614
Mailing Address - Fax:305-652-3616
Practice Address - Street 1:7 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4516
Practice Address - Country:US
Practice Address - Phone:305-652-3614
Practice Address - Fax:305-652-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine