Individual
MR. BENJAMIN ROLAND CRUMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(321) 841-7700
(321) 841-7799
Mailing address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(321) 841-7700
(321) 841-7799
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9106161
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014837200
—
FL
01
—
PA9106161
MEDICAL LICENSE
FL
Enumeration date
02/10/2009
Last updated
11/15/2016
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