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NPI Code Detail

MEDICARE: INDIAN RIVER PHYSICIANS LLC

MEDICARE: INDIAN RIVER PHYSICIANS LLC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1558798470
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDIAN RIVER PHYSICIANS LLC
Provider Business Mailing Address
First Line : 1986 35TH AVE
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-2533
Country : US
Telephone Number : 772-562-9339
Fax Number :
Provider Business Practice Location Address
First Line : 1986 35TH AVE
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-2533
Country : US
Telephone Number : 772-562-9339
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : DR. JOSEPH P CRAWFORD
Credential : M.D.
Telephone Number : 772-562-9339
Provider Enumeration Date : 10/09/2013
Last Update Date : 10/09/2013

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Directions to “INDIAN RIVER PHYSICIANS LLC ” Practice Location

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