Healthcare Provider Details

I. General information

NPI: 1780508317
Provider Name (Legal Business Name): CRYSTAL THOMAS FEARING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3632 LAND O LAKES BLVD STE 105-11
LAND O LAKES FL
34639-4405
US

IV. Provider business mailing address

3632 LAND O LAKES BLVD STE 105-11
LAND O LAKES FL
34639-4405
US

V. Phone/Fax

Practice location:
  • Phone: 727-232-9922
  • Fax: 727-232-9922
Mailing address:
  • Phone: 727-232-9922
  • Fax: 727-232-9922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: