Individual
CHARAMINE E CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5100 1ST AVE S, SAINT PETERSBURG, FL 33707-1802
(727) 479-9225
Mailing address
5100 1ST AVE S, SAINT PETERSBURG, FL 33707-1802
(727) 479-9225
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
23525834Z
FL
Other
Enumeration date
01/07/2026
Last updated
01/07/2026
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