Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | ME0046399 | FL |
N | 2081S0010X | Sports Medicine | ME0046399 | FL |
N | 213ES0000X | Sports Medicine | ME0046399 | FL |
NPI | 1376673178 |
---|---|
Provider Name | Luis E Crespo |
First Address | Tampa, FL 33607-3851 |
Second Address | Tampa, FL 33607-3851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E53020 | (02) | FL |