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General NPI Number Information
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NPI Number | 1316400260
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Entity Type | Individual
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Provider Name | CRYSTAL TAO PERKINS MD
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Gender | Female
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 2600 WESTHALL LN STE 4
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City | MAITLAND
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State | FL
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Zip | 32751-7102
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Country | US
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Telephone | 407-200-2355
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Fax | 407-200-4947
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Provider Business Mailing Address
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Address Line | 2600 WESTHALL LN STE 4
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City | MAITLAND
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State | FL
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Zip | 32751-7102
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Country | US
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Telephone | 407-200-2355
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Fax | 407-200-4947
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 1017992
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME175305
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License Number State | FL
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