Provider Demographics
NPI:1669473252
Name:DECROOS, FRANCIS CF (MD)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:CF
Last Name:DECROOS
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 1:928 E MR WALT DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6601
Mailing Address - Country:US
Mailing Address - Phone:850-862-4377
Mailing Address - Fax:850-862-6015
Practice Address - Street 1:928 MAR WALT DR
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6706
Practice Address - Country:US
Practice Address - Phone:850-862-4377
Practice Address - Fax:850-862-6015
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-09
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
FLME0027347207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL46110ZMedicare ID - Type UnspecifiedGROUP NUMBER
FLD54949Medicare UPIN