Individual
STEPHANIE CRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
19621 COCHRAN BLVD, PORT CHARLOTTE, FL 33948-2070
(954) 262-1250
Mailing address
490 LOMOND DR, PORT CHARLOTTE, FL 33953-1526
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
9117891
FL
Other
Enumeration date
01/04/2022
Last updated
10/03/2023
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