Provider Demographics
NPI:1063659167
Name:MICHAEL A CRAVEN DC PA
Entity Type:Organization
Organization Name:MICHAEL A CRAVEN DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-996-9800
Mailing Address - Street 1:5420 LAND O LAKES BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-3401
Mailing Address - Country:US
Mailing Address - Phone:813-996-9800
Mailing Address - Fax:813-996-3326
Practice Address - Street 1:5420 LAND O LAKES BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-3401
Practice Address - Country:US
Practice Address - Phone:813-996-9800
Practice Address - Fax:813-996-3326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center