Individual
JACQUELYN FARYN CREWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5528 NW 43RD ST, GAINESVILLE, FL 32653-3301
(352) 265-3604
(352) 627-4892
Mailing address
1699 SW 16TH AVE, GAINESVILLE, FL 32608-1158
(352) 265-3604
(352) 627-4892
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
131145
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020389300
—
FL
01
—
131145
MEDICAL LICENSE
FL
Enumeration date
05/23/2014
Last updated
09/12/2024
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