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Individual

DR. TERRENCE ALLAN CRONIN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1399 S HARBOR CITY BLVD, MELBOURNE, FL 32901-3208
(321) 726-1711
(321) 726-1715
Mailing address
1399 S HARBOR CITY BLVD, MELBOURNE, FL 32901-3208
(321) 726-1711
(321) 726-1715

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME0066760
FL
207NS0135X
Procedural Dermatology Physician
ME0066760
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070007155
RAILROAD MEDICARE
FL
01
18258
AETNA
FL
01
26265
FLORIDA BLUE SHIELD
FL
05
379600100
FL
01
6189190
CIGNA
Enumeration date
08/11/2005
Last updated
09/08/2008
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