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General NPI Number Information
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NPI Number | 1093356842
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Entity Type | Organization
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Legal Business Name | CREW COMMUNITY HEALTH, INC
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 8601 COMMODITY CIRCLE
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 407-605-2252
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Fax | 855-750-3960
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Provider Business Mailing Address
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Address Line | 8601 COMMODITY CIRCLE
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 407-605-2253
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Fax | 855-750-3960
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MR. STERLING BRODNIAK
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Credential | DO
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Telephone | 407-605-2253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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