MEDICARE: CRAIG W. ENGLUND, MD, 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	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598805749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAIG W. ENGLUND, MD, PA

Provider Business Mailing Address
First Line	:	770 SE 5TH TER
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-4852
Country	:	US
Telephone Number	:	352-637-4490
Fax Number	:	352-637-3987

Provider Business Practice Location Address
First Line	:	801 MEDICAL CT E
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34452-4623
Country	:	US
Telephone Number	:	352-637-4490
Fax Number	:	352-637-3987

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SERVILLANO E DELA CRUZ, JR.
Credential	:	M.D.
Telephone Number	:	352-795-6674

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	06/20/2008

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