| Crystal M Peterson, CNM | |
|
400 Celebration Pl, Celebration, FL 34747-4970 | |
| (407) 975-0406 | |
| (407) 975-0407 |
| Full Name | Crystal M Peterson |
|---|---|
| Gender | Female |
| Speciality | Advanced Practice Midwife |
| Location | 400 Celebration Pl, Celebration, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932444965 | NPI | - | NPPES |
| 103732800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | APRN11002022 (Florida) | Secondary |
| 367A00000X | Advanced Practice Midwife | APRN11002022 (Florida) | Primary |
| Entity Name | Florida Hospital Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225034234 PECOS PAC ID: 0749186153 Enrollment ID: O20031208000807 |
| Entity Name | Womens Care Florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013902923 PECOS PAC ID: 9234031444 Enrollment ID: O20040127000078 |
| Entity Name | Key West Hma Physician Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871548651 PECOS PAC ID: 0749178408 Enrollment ID: O20040305000837 |
| Entity Name | Orlando Health Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669429577 PECOS PAC ID: 9537059084 Enrollment ID: O20040318000044 |
| Entity Name | Pediatrix Medical Group Of Florida Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083711790 PECOS PAC ID: 4486634417 Enrollment ID: O20040721000998 |
| Entity Name | Womens' Health Hospitalists, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205295599 PECOS PAC ID: 1850674870 Enrollment ID: O20170216001354 |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal M Peterson, CNM 1832 Merrivale Loop, Ocoee, FL 34761-5215 Ph: (516) 528-5779 | Crystal M Peterson, CNM 400 Celebration Pl, Celebration, FL 34747-4970 Ph: (407) 975-0406 |
Kiya Nichole Fox, Advanced Practice Midwife Medicare: May Accept Medicare Assignments Practice Location: 400 Celebration Pl, Celebration, FL 34747 Phone: 407-975-0406 Fax: 407-975-0407 |