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NPI Code Detail

MEDICARE: ISAAC CRAWFORD

MEDICARE: ISAAC CRAWFORD
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
1106S00000XBehavior Technician

Other Identifiers

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

General Provider Information

NPI Number : 1699329755
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISAAC CRAWFORD
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 866-610-0580
Fax Number :
Provider Business Practice Location Address
First Line : 2100 N ALAFAYA TRL STE 300
Second Line :
City : ORLANDO
State : FL
Zip : 32826-4748
Country : US
Telephone Number : 407-720-4101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2019
Last Update Date : 07/27/2019

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Directions to “ ISAAC CRAWFORD ” Practice Location

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