Basic Information
| Provider Information | |||||||||
| NPI: | 1568188076 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ CRESPO | ||||||||
| FirstName: | REINIER | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 LORI DR APT 110 | ||||||||
| Address2: | |||||||||
| City: | PALM SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334611258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612226943 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1800 SE TIFFANY AVE | ||||||||
| Address2: | |||||||||
| City: | PORT ST LUCIE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349527521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7723354000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2022 | ||||||||
| LastUpdateDate: | 10/17/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 11022084 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.