Provider Demographics
NPI:1093084709
Name:DEBRA M. ASHCRAFT, MD, LLC
Entity Type:Organization
Organization Name:DEBRA M. ASHCRAFT, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ASHCRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-447-5886
Mailing Address - Street 1:4828 THORPE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-1156
Mailing Address - Country:US
Mailing Address - Phone:407-447-5886
Mailing Address - Fax:407-447-5927
Practice Address - Street 1:4828 THORPE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1156
Practice Address - Country:US
Practice Address - Phone:407-447-5886
Practice Address - Fax:407-447-5927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-26
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1774171100000X
FLME49757208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty