Healthcare Provider Details

I. General information

NPI: 1124077441
Provider Name (Legal Business Name): JOSEPH P. CRAWFORD, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1986 35TH AVE
VERO BEACH FL
32960-2533
US

IV. Provider business mailing address

1986 35TH AVE
VERO BEACH FL
32960-2533
US

V. Phone/Fax

Practice location:
  • Phone: 772-562-7220
  • Fax: 772-562-5476
Mailing address:
  • Phone: 772-562-7220
  • Fax: 772-562-5476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME46397
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME83321
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberME51265
License Number StateFL

VIII. Authorized Official

Name: MR. THOMAS MICHAEL SHEA
Title or Position: ADMINISTRATOR
Credential:
Phone: 772-562-9339