Provider Demographics
NPI:1659356632
Name:CRAWFORD, CYNTHIA S (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:S
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1986 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2533
Mailing Address - Country:US
Mailing Address - Phone:772-778-2107
Mailing Address - Fax:772-562-5476
Practice Address - Street 1:1986 35TH AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-2533
Practice Address - Country:US
Practice Address - Phone:772-778-2107
Practice Address - Fax:772-562-5476
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046877208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
31184OtherBCBS
31184OtherBCBS
D54252Medicare UPIN