Provider Demographics
NPI:1265763783
Name:LLEWELLYN, CRAIG HARTMAN (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:HARTMAN
Last Name:LLEWELLYN
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 PINE HOV CIR
Mailing Address - Street 2:APT D-1
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-9246
Mailing Address - Country:US
Mailing Address - Phone:240-472-5559
Mailing Address - Fax:
Practice Address - Street 1:235 PINE HOV CIR
Practice Address - Street 2:APT D-1
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-9246
Practice Address - Country:US
Practice Address - Phone:240-472-5559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00348012083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine