Individual
MARIA WALLIS-CRESPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6500 38TH AVE N, ST PETERSBURG, FL 33710-1629
(727) 341-4874
(727) 341-4925
Mailing address
11645 DELWICK DR, WINDERMERE, FL 34786
(407) 258-8100
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME91778
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME91778
MEDICAL LICENSE
FL
Enumeration date
01/04/2007
Last updated
06/16/2023
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