Individual
JOHN CROGNALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
11373 CORTEZ BLVD, SUITE 300, BROOKSVILLE, FL 34613-5414
(352) 597-9095
(352) 597-1446
Mailing address
15215 CORTEZ BLVD, BROOKSVILLE, FL 34613-6072
(352) 799-0046
(352) 597-1446
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1694
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291499900
—
FL
01
—
Y01EK
BCBS
FL
Enumeration date
10/12/2006
Last updated
07/21/2022
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