Crater, Dana Debord

Crater, Dana Debord is an sole proprietor health care provider with primary practice located at 9350 Camelot Dr , Fort Myers FL 33919-7980. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Crater, Dana Debord can be contacted via phone (239) 481-5437.

Contact Information

Primary practice address
9350 Camelot Dr Fort Myers FL 33919-7980
Phone: (239) 481-5437
Fax: (239) 481-0570
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME102094 Florida

Profile Details

NPI number 1043285547
LBN Legal business name Crater, Dana Debord
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 20th, 2006
Last updated May 21st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043285547 NPPES
Florida MEDICAID 000697700

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