Provider Demographics
NPI:1225324726
Name:CRAWFORD-HARRIS, PAULA ANDREA MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:ANDREA MICHELLE
Last Name:CRAWFORD-HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:293 NW PEACOCK BLVD STE 101-104
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2222
Mailing Address - Country:US
Mailing Address - Phone:772-335-9600
Mailing Address - Fax:772-879-4478
Practice Address - Street 1:293 NW PEACOCK BLVD STE 101-104
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986
Practice Address - Country:US
Practice Address - Phone:772-335-9600
Practice Address - Fax:772-879-4478
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116024013207Q00000X
FLME134401207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine