Healthcare Provider Details

I. General information

NPI: 1700280401
Provider Name (Legal Business Name): PATRICIA SWANN CRTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2014
Last Update Date: 10/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449 MACGREGOR RD
WINTER SPRINGS FL
32708-5336
US

IV. Provider business mailing address

449 MACGREGOR RD
WINTER SPRINGS FL
32708-5336
US

V. Phone/Fax

Practice location:
  • Phone: 407-252-4760
  • Fax:
Mailing address:
  • Phone: 407-252-4760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberTT3744
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: