Provider Demographics
NPI:1558416867
Name:CROSS, CARTRELL JAMES (MD)
Entity Type:Individual
Prefix:
First Name:CARTRELL
Middle Name:JAMES
Last Name:CROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 9TH ST N
Mailing Address - Street 2:#100
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5885
Mailing Address - Country:US
Mailing Address - Phone:239-213-7000
Mailing Address - Fax:239-430-7824
Practice Address - Street 1:311 9TH ST N
Practice Address - Street 2:#100
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5885
Practice Address - Country:US
Practice Address - Phone:239-213-7000
Practice Address - Fax:239-430-7824
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114373207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14P4DOtherBCBS
FLP01302641OtherRR MEDICARE
FL008089900Medicaid
FLP01302641OtherRR MEDICARE