Provider Demographics
NPI:1508072547
Name:CROSSKEY, JANIS LENA (OD)
Entity Type:Individual
Prefix:DR
First Name:JANIS
Middle Name:LENA
Last Name:CROSSKEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7314 S DE SOTO ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33616-2108
Mailing Address - Country:US
Mailing Address - Phone:904-742-3018
Mailing Address - Fax:
Practice Address - Street 1:3501 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4860
Practice Address - Country:US
Practice Address - Phone:963-644-9461
Practice Address - Fax:963-644-0336
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2724152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist