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General NPI Number Information
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NPI Number | 1649937228
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Entity Type | Individual
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Provider Name | CRYSTAL SPERANZA APRN
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Gender | Female
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 17 N SUMMERLIN AVE STE 100
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City | ORLANDO
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State | FL
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Zip | 32801-2951
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Country | US
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Telephone | 407-250-6133
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 ALDEN RD APT 327
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City | ORLANDO
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State | FL
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Zip | 32803-1949
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Country | US
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Telephone | 561-601-0409
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 11015756
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License Number State | FL
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