Provider Demographics
NPI:1861718348
Name:CRESPO, ZAIDA IVELISSE (MSA)
Entity type:Individual
Prefix:MRS
First Name:ZAIDA
Middle Name:IVELISSE
Last Name:CRESPO
Suffix:
Gender:F
Credentials:MSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34434
Mailing Address - Street 2:
Mailing Address - City:FORT BUCHANAN
Mailing Address - State:PR
Mailing Address - Zip Code:00934-0434
Mailing Address - Country:US
Mailing Address - Phone:787-502-8997
Mailing Address - Fax:
Practice Address - Street 1:ST. 21 #1785 HOSPITAL METROPOLITANO SUITE 206
Practice Address - Street 2:LAS LOMAS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-781-0644
Practice Address - Fax:787-780-5923
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR526231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist