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NPI Code Detail

MEDICARE: DR. GORDON JOHNSON CROZIER DO

MEDICARE: DR. GORDON JOHNSON CROZIER DO
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
12083P0901XPublic Health & General Preventive Medicine PhysicianOS11510FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DO0000001336OTHERTNLICENSE
2582636039OTHERTNTAX ID

General Provider Information

NPI Number : 1265529200
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GORDON JOHNSON CROZIER DO
Provider Business Mailing Address
First Line : 1307 S INTERNATIONAL PKWY
Second Line : 2071
City : LAKE MARY
State : FL
Zip : 32746-1413
Country : US
Telephone Number : 606-776-7707
Fax Number : 407-732-7669
Provider Business Practice Location Address
First Line : 1307 S INTERNATIONAL PKWY
Second Line : SUITE 2071
City : LAKE MARY
State : FL
Zip : 32746-1413
Country : US
Telephone Number : 606-776-7707
Fax Number : 407-732-7669
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 03/07/2023

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