Healthcare Provider Details

I. General information

NPI: 1790646222
Provider Name (Legal Business Name): BRITTANY ESTELLE CROWDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9985 PRITCHARD RD
JACKSONVILLE FL
32219-2894
US

IV. Provider business mailing address

9985 PRITCHARD RD
JACKSONVILLE FL
32219-2894
US

V. Phone/Fax

Practice location:
  • Phone: 904-378-4652
  • Fax: 904-378-4811
Mailing address:
  • Phone: 904-378-4652
  • Fax: 904-378-4811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: