MEDICARE: DEREK MCCRANIE

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	208600000X	Surgery Physician	166283	FL

General Provider Information

NPI Number	:	1669960134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEREK MCCRANIE

Provider Business Mailing Address
First Line	:	1812 HIGHWAY 441 NORTH
Second Line	:	SUITE 310
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972
Country	:	US
Telephone Number	:	863-357-1510
Fax Number	:

Provider Business Practice Location Address
First Line	:	3440 TAMIAMI TRL UNIT 1
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-8134
Country	:	US
Telephone Number	:	941-235-8217
Fax Number	:

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

Provider Enumeration Date	:	04/30/2018
Last Update Date	:	06/16/2026

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Directions to “ DEREK MCCRANIE ” Practice Location

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