Healthcare Provider Details

I. General information

NPI: 1073513321
Provider Name (Legal Business Name): JANET CRAWFORD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date: 07/28/2005
Reactivation Date: 01/25/2007

III. Provider practice location address

2111 SW 20TH PL
OCALA FL
34471-7734
US

IV. Provider business mailing address

521 W STATE ROAD 434 STE 307
LONGWOOD FL
32750-5166
US

V. Phone/Fax

Practice location:
  • Phone: 352-622-4251
  • Fax: 352-622-0102
Mailing address:
  • Phone: 321-841-6444
  • Fax: 407-650-1307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN9458466
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: