MEDICARE: CRAWFORD CENTER, INC.

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	251V00000X	Voluntary or Charitable Agency	N95000004564	FL

General Provider Information

NPI Number	:	1619925922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAWFORD CENTER, INC.

Provider Business Mailing Address
First Line	:	3521 W BROWARD BLVD
Second Line	:	THIRD FLOOR
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-1048
Country	:	US
Telephone Number	:	954-587-1008
Fax Number	:

Provider Business Practice Location Address
First Line	:	3521 W BROWARD BLVD
Second Line	:	THIRD FLOOR
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-1048
Country	:	US
Telephone Number	:	954-587-1008
Fax Number	:

Authorized Official
Title or Position	:	C.O.O/GENERAL COUNSEL
Name	:	MR. EDUARDO R. LACASA
Credential	:	JD
Telephone Number	:	954-587-1008

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	08/22/2020

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