Provider Demographics
NPI:1124849492
Name:CRESPO HERNANDEZ, ROXANA MARIA (APRN)
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:MARIA
Last Name:CRESPO HERNANDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 E 40TH ST APT 15
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-2834
Mailing Address - Country:US
Mailing Address - Phone:786-273-6373
Mailing Address - Fax:
Practice Address - Street 1:850 E 40TH ST APT 15
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-2834
Practice Address - Country:US
Practice Address - Phone:786-273-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035585363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily