Organization
CRESTVIEW HOSPITAL COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MUSIC (DIR, ONBOARDING & PROV ENROLLMENT)
(877) 892-9815
Entity
Organization
Contact information
Practice address
151 E REDSTONE AVE, CRESTVIEW, FL 32539-5352
(850) 689-8100
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 628-6038
(615) 628-6832
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267192100
—
FL
01
—
34833
BCBS
FL
01
—
40043
BCBS
FL
01
—
40043A
BCBS
FL
05
—
529921440
—
AL
05
—
660049201
—
FL
05
—
660049202
—
FL
05
—
660058100
—
FL
05
—
660058101
—
FL
Enumeration date
05/08/2006
Last updated
11/09/2023
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