Provider Demographics
NPI:1942497201
Name:CROSBY, SUE PRATO (RN, AP, DIPL OM)
Entity Type:Individual
Prefix:MRS
First Name:SUE
Middle Name:PRATO
Last Name:CROSBY
Suffix:
Gender:F
Credentials:RN, AP, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 NW 21ST PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3939
Mailing Address - Country:US
Mailing Address - Phone:352-372-1673
Mailing Address - Fax:
Practice Address - Street 1:1031 NW 6TH ST
Practice Address - Street 2:SUITE D-1
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-2226
Practice Address - Country:US
Practice Address - Phone:352-224-5085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLA AP #1895171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC-0920OtherBLUE CROSS/BLUE SHIELD