Organization
ISPM OF FLORIDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SAMANTHA A CRANDALL (ADMINISTRATOR)
(941) 205-0270
Entity
Organization
Contact information
Practice address
610 EAST OLYMPIA BLVD, STE 202, PUNTA GORDA, FL 33950-3875
(941) 833-1100
(941) 637-0437
Mailing address
3400 PEACHTREE RD NE, STE 811, ATLANTA, GA 30326-1107
(941) 205-0270
(941) 205-0276
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
04/28/2010
Last updated
08/24/2012
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