Dejesus, Crystal

Dejesus, Crystal is an individual health care provider with primary practice located at 19735 Us Highway 441 Fl 1 , Mount Dora FL 32757-2204. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Dejesus, Crystal can be contacted via phone (352) 735-5700.

Contact Information

Primary practice address
19735 Us Highway 441 Fl 1 Mount Dora FL 32757-2204
Phone: (352) 735-5700
Fax: (352) 735-5701
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9106616 Florida

Profile Details

NPI number 1063775765
LBN Legal business name Dejesus, Crystal
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2012
Last updated Sep 25th, 2023 - about 3 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 1063775765 NPPES
Florida Other PA9106616 LICENSE

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