Individual
CRAIG R CAZENAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(614) 210-1885
(614) 210-1886
Mailing address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(614) 210-1885
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME42584
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000101258
—
AL
05
—
048160200
—
FL
01
—
05668
BCBS
FL
05
—
104205
—
AL
05
—
104206
—
AL
05
—
104236
—
AL
05
—
104239
—
AL
05
—
104250
—
AL
05
—
104466
—
AL
05
—
104468
—
AL
05
—
104470
—
AL
05
—
107070
—
AL
05
—
107073
—
AL
05
—
108288
—
AL
05
—
108893
—
AL
05
—
109478
—
AL
Enumeration date
01/27/2006
Last updated
11/12/2014
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