Individual
DR. CRISTAL SUZANNE GRANT-SPENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
9121 NW 17TH ST, PLANTATION, FL 33322-4338
(954) 304-0121
Mailing address
9121 NW 17TH ST, PLANTATION, FL 33322-4338
(954) 304-0121
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
65 006287
NY
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO 3361
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BE916Z
MEDICARE PTAN
FL
Enumeration date
07/09/2008
Last updated
07/21/2022
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