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NPI Code Detail

MEDICARE: DR. DANIELLE VENEGONIA CRAWFORD DPM

MEDICARE: DR. DANIELLE VENEGONIA CRAWFORD DPM
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
1213E00000XPodiatrist01534MD
2213ES0103XFoot & Ankle Surgery PodiatristPO4012FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760779573
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIELLE VENEGONIA CRAWFORD DPM
Provider Business Mailing Address
First Line : 1600 E GUDE DR
Second Line : SUITE 200
City : ROCKVILLE
State : MD
Zip : 20850-1341
Country : US
Telephone Number : 301-933-7133
Fax Number : 301-933-7137
Provider Business Practice Location Address
First Line : 6841 BLANDING BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32244-4418
Country : US
Telephone Number : 904-862-2175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2011
Last Update Date : 03/01/2019

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