MEDICARE: CRANIAL CRUSH & CO 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
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1730025297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRANIAL CRUSH & CO LLC

Provider Business Mailing Address
First Line	:	641 CORNELIA CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-4340
Country	:	US
Telephone Number	:	689-307-6771
Fax Number	:

Provider Business Practice Location Address
First Line	:	641 CORNELIA CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-4340
Country	:	US
Telephone Number	:	689-307-6771
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JANIYA FRAZIER
Credential	:
Telephone Number	:	689-307-6771

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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Directions to “CRANIAL CRUSH & CO LLC ” Practice Location

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