Active NPI
Lea Rose Crestodina, ARNP
- Wound Care Registered Nurse
- Hollywood, FL
National Provider Identifier
1427394022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Wound Care Registered Nurse
- License
- 1803582
- Practice address
- 3501 Johnson St
Diabetes Center
Hollywood, FL 33021-5421 - Phone
- (954) 265-5856
- NPI assigned
- Dec 31, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Wound Care Registered Nurse | 163WW0000X | 1803582 | FL | Primary |
Addresses
Primary practice location
3501 Johnson St
Diabetes Center
Hollywood, FL 33021-5421
Mailing address
3501 Johnson St
Diabetes Center
Hollywood, FL 33021-5421
Phone (954) 265-5856
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1803582 | FL | MD | Wound Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356912000000",
"number": "1427394022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3501 JOHNSON ST",
"address_2": "DIABETES CENTER",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330215421",
"telephone_number": "954-265-5856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 JOHNSON ST",
"address_2": "DIABETES CENTER",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330215421",
"telephone_number": "954-265-5856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRESTODINA",
"first_name": "LEA",
"middle_name": "ROSE",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-31",
"last_updated": "2012-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "163WW0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Wound Care",
"state": "FL",
"license": "1803582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.