Healthcare Provider Details

I. General information

NPI: 1194643882
Provider Name (Legal Business Name): JOSEPH CRUMPTON CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 WIREGRASS RANCH BLVD
WESLEY CHAPEL FL
33543-4274
US

IV. Provider business mailing address

5085 POST OAK BLVD APT 304
WESLEY CHAPEL FL
33544-5494
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-5111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number100293990
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: