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General NPI Number Information
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NPI Number | 1205043684
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Entity Type | Individual
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Provider Name | CRAIG CZYZ D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 21178 OLEAN BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6728
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Country | US
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Telephone | 941-629-1090
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 OREGON AVE
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City | COLUMBUS
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State | OH
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Zip | 43201-3371
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Country | US
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Telephone | 614-395-5644
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Fax | 614-297-7753
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 58-001590
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | OS10225
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number | OS10225
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number | 34.009294
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number | OS014584
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | OS014584
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License Number State | PA
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