Provider Demographics
NPI:1801239520
Name:DIXON, CRYSTAL (MD)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:
Other - Last Name:PERREAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3848 FAU BLVD STE 31
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6437
Mailing Address - Country:US
Mailing Address - Phone:305-243-3100
Mailing Address - Fax:561-393-7312
Practice Address - Street 1:3848 FAU BLVD STE 31
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6437
Practice Address - Country:US
Practice Address - Phone:305-243-3100
Practice Address - Fax:561-393-7312
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1309672084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology