Healthcare Provider Details

I. General information

NPI: 1609203835
Provider Name (Legal Business Name): CYNTHIA S. CRAWFORD, M.D. PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 02/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1986 35TH AVENUE
VERO BEACH FL
32960
US

IV. Provider business mailing address

PO BOX 411373
MELBOURNE FL
32941-1373
US

V. Phone/Fax

Practice location:
  • Phone: 772-360-4306
  • Fax: 772-778-3321
Mailing address:
  • Phone: 772-360-4306
  • Fax: 772-778-3321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MIGUEL A RIVERA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 772-360-4306