Individual
DR. CRAIG DEPODESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
231B COMMERCIAL BLVD, LAUDERDALE BY THE SEA, FL 33308-4441
(954) 530-1600
(954) 306-8234
Mailing address
PO BOX 132, POMPANO BEACH, FL 33061-0132
(954) 530-1600
(954) 306-8234
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS8042
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261110400
—
FL
Enumeration date
06/16/2005
Last updated
11/05/2009
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