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General NPI Number Information
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NPI Number | 1497212799
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Entity Type | Individual
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Provider Name | EDGAR JOEL CRUZ CRISPIN DNP, APRN
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Gender | Male
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Dates
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Enumeration Date | 02/23/2019
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 17835 MURDOCK CIR UNIT A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-4091
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Country | US
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Telephone | 941-340-3636
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Fax | 941-340-3637
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Provider Business Mailing Address
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Address Line | 17835 MURDOCK CIR UNIT A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-4091
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Country | US
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Telephone | 941-340-3636
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Fax | 941-340-3637
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11001601
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11001601
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License Number State | FL
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