MEDICARE: MICHAEL A CRAVEN DC PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1063659167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL A CRAVEN DC PA

Provider Business Mailing Address
First Line	:	5420 LAND O LAKES BLVD
Second Line	:	SUITE 105
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-3401
Country	:	US
Telephone Number	:	813-996-9800
Fax Number	:	813-996-3326

Provider Business Practice Location Address
First Line	:	5420 LAND O LAKES BLVD
Second Line	:	SUITE 105
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-3401
Country	:	US
Telephone Number	:	813-996-9800
Fax Number	:	813-996-3326

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL A CRAVEN
Credential	:	D.C.
Telephone Number	:	813-996-9800

Provider Enumeration Date	:	01/12/2009
Last Update Date	:	01/14/2009

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