Provider Demographics
NPI:1649389529
Name:CRANKSHAW, ROBERT N (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:CRANKSHAW
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4671
Mailing Address - Street 2:
Mailing Address - City:DOWLING PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32064-1507
Mailing Address - Country:US
Mailing Address - Phone:386-658-5118
Mailing Address - Fax:386-658-2108
Practice Address - Street 1:11057 COUNTY ROAD 136
Practice Address - Street 2:
Practice Address - City:DOWLING PARK
Practice Address - State:FL
Practice Address - Zip Code:32060-5890
Practice Address - Country:US
Practice Address - Phone:386-658-5118
Practice Address - Fax:386-658-2108
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 0320106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist