Individual
KATIE WEISZ CREMATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3635 CLYDE MORRIS BLVD STE 100, PORT ORANGE, FL 32129-2349
(386) 788-7842
(386) 756-8802
Mailing address
4800 BELFORT RD, JACKSONVILLE, FL 32256-6004
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9110239
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020626200
—
FL
Enumeration date
04/07/2017
Last updated
02/23/2022
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