Basic Information
| Provider Information | |||||||||
| NPI: | 1790990851 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANCHEZ-CRESPO | ||||||||
| FirstName: | NELIA | ||||||||
| MiddleName: | ESTHER | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 433 HIGHLAND AVE NE APT 1150 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303121398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4045078381 | ||||||||
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| Practice Location | |||||||||
| Address1: | 806 S DOUGLAS RD | ||||||||
| Address2: | SUITE 820 | ||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331343157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054474150 | ||||||||
| FaxNumber: | 3056758068 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2007 | ||||||||
| LastUpdateDate: | 08/06/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 000637 | GA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 28318 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 009912077 | 05 | AL | MEDICAID | 285968434A | 05 | GA | MEDICAID | 51006878 | 01 | AL | BCBS OF AL | OTHER |