| John B Crescitelli D.o. P.a. | |
|
1 W Sample Rd Suite 302 Pompano Beach FL 33064-3547 | |
| (954) 366-3332 | |
| (954) 366-4523 |
| Full Name | John B Crescitelli D.o. P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 W Sample Rd, Pompano Beach, Florida |
| Authorized Official Name and Position | John B Crescitelli (PHYSICIAN/OWNER) |
| Authorized Official Contact | 9543831867 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John B Crescitelli D.o. P.a. 5944 Coral Ridge Dr #167 Coral Springs FL 33076-3300 Ph: (954) 383-1867 | John B Crescitelli D.o. P.a. 1 W Sample Rd Suite 302 Pompano Beach FL 33064-3547 Ph: (954) 366-3332 |
| NPI Number | 1134666423 |
|---|---|
| Provider Enumeration Date | 01/24/2017 |
| Last Update Date | 01/24/2017 |
| Medicare PECOS PAC ID | 8325315856 |
|---|---|
| Medicare Enrollment ID | O20170605000182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134666423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 7485 (Florida) | Primary |
| Provider Name | John B Crescitelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558368225 PECOS PAC ID: 5698828358 Enrollment ID: I20090729000249 |
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