Healthcare Provider Details

I. General information

NPI: 1245705318
Provider Name (Legal Business Name): KRYSTAL PARMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 11/10/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6804 CECELIA DRIVE
NEW PORT RICHEY FL
34653-4935
US

IV. Provider business mailing address

6804 CECELIA DRIVE
NEW PORT RICHEY FL
34653-4935
US

V. Phone/Fax

Practice location:
  • Phone: 855-232-0644
  • Fax: 888-546-0488
Mailing address:
  • Phone: 855-232-0644
  • Fax: 888-546-0488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberAPRN11012163
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number101966
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11012163
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: