Crockett, Samuel E

Crockett, Samuel E is an individual health care provider with primary practice located at 2520 N Orange Ave Suite 102, Orlando FL 32804-4638. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Crockett, Samuel E can be contacted via phone (407) 303-2801.

Contact Information

Primary practice address
2520 N Orange Ave Suite 102 Orlando FL 32804-4638
Phone: (407) 303-2801
Fax: (407) 303-2805
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X ME31027 Florida

Profile Details

NPI number 1679517171
LBN Legal business name Crockett, Samuel E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Aug 17th, 2007 - about 17 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 1679517171 NPPES
Florida Other 48932 BCBS

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