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NPI Code Detail

MEDICARE: CRYSTAL LEE PARRISH

MEDICARE:   CRYSTAL LEE PARRISH
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
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1528676772
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL LEE PARRISH
Provider Business Mailing Address
First Line : PO BOX 1945
Second Line : 665 U.S 17 NORTH # 1945
City : EAGLE LAKE
State : FL
Zip : 33839
Country : US
Telephone Number : 863-667-6055
Fax Number :
Provider Business Practice Location Address
First Line : 3139 WHISPERING TRAILS ST
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-1846
Country : US
Telephone Number : 863-667-6055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2020
Last Update Date : 07/14/2020

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