Healthcare Provider Details

I. General information

NPI: 1710053590
Provider Name (Legal Business Name): DAVID ANTHONY CRAGLE RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD
TAMPA FL
33612-4745
US

IV. Provider business mailing address

4948 PELICAN DR
NEW PORT RICHEY FL
34652-4425
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-2000
  • Fax:
Mailing address:
  • Phone: 813-848-3813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT 7201
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: