Provider Demographics
NPI:1538834973
Name:CRESPO, JEREMY CHARLES (APRN, FNP-C)
Entity type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:CHARLES
Last Name:CRESPO
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Gender:M
Credentials:APRN, FNP-C
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Mailing Address - Street 1:909 RIDGEBROOK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SPARKS GLENCOE
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9477
Mailing Address - Country:US
Mailing Address - Phone:443-383-9300
Mailing Address - Fax:855-866-8710
Practice Address - Street 1:2875 NE 191ST ST STE 500
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2832
Practice Address - Country:US
Practice Address - Phone:443-383-9300
Practice Address - Fax:855-866-8710
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2022-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN1013953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily