MEDICARE: DR. KRISTY G CRAWFORD D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	OS13959	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457641912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTY G CRAWFORD D.O.

Provider Business Mailing Address
First Line	:	1000 36TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-4862
Country	:	US
Telephone Number	:	772-567-4311
Fax Number	:	772-794-1450

Provider Business Practice Location Address
First Line	:	1050 37TH PL
Second Line	:	SUITES 101 - 103
City	:	VERO BEACH
State	:	FL
Zip	:	32960-6501
Country	:	US
Telephone Number	:	772-770-6116
Fax Number	:	772-794-1450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2011
Last Update Date	:	08/25/2016

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