SAMUEL E CROCKETT


Address: 2520 N Orange Ave, Suite 102, Orlando, FL 32804-4638
Phone: 4073032801

SAMUEL E CROCKETT (NPI# 1679517171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679517171
Entity Type Individual
Full Name SAMUEL E CROCKETT
Credential MD
Practice Address 2520 N Orange Ave
Suite 102
Orlando
FL 32804-4638
Practice Telephone 4073032801
Practice Fax Number 4073032805
Mailing Telephone 4073032801
Mailing Fax Number 4073032805
Enumeration Date 2006-06-15
Last Update Date 2007-08-17
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RE0101X Internal Medicine
Specialization: Endocrinology, Diabetes & Metabolism
ME31027 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL BCBS 48932 01

Other Providers SAMUEL CROCKETT

NPI Name Taxonomy Address Enumeration
1669448957 Samuel R. Crockett IIi Anesthesiology 1000 E Mountain Blvd, Dept of Anesthesia, Wilkes Barre, PA 18711-0027 2006-02-27

Office Location

Street Address 2520 N ORANGE AVE
SUITE 102
City ORLANDO
State FL
Zip Code 32804-4638

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255853057 Chante Perry Physical Medicine & Rehabilitation 2520 N Orange Ave, Orlando, FL 32804-4638 2017-07-13
1699812537 Angela Danielle Mazza Internal Medicine 2520 N Orange Ave, #102, Orlando, FL 32804-4638 2007-01-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1881252716 Alyssa Bass Counselor 3130 Edgewater Dr, Orlando, FL 32804 2019-06-05
1841856366 Debora Cheryl Ramirez Technician/Technologist 1231 North Orange Ave, Orlando, FL 32804 2019-05-10
1679074009 Jessica Dobbs Counselor 3801 Grant Blvd, Orlando, FL 32804 2018-02-21
1881109031 Pedro Mendez Jr. Counselor 1800 W. Colonial Drive, Orlando, FL 32804 2017-12-11
1902259310 Michael Lo Nurse Practitioner 2400 N Orange Ave Ste 302, Orlando, FL 32804 2016-07-20
1083093595 Michael Gregg Student in an Organized Health Care Education/Training Program 2415 North Orange Avenue, Suite 400, Orlando, FL 32804 2015-05-29
1922485473 Lindsay Rae Piet Physician Assistant 1910 N. Orange Ave., Orlando, FL 32804 2015-05-05
1093106189 College Park Community Acupuncture & Herbal Medicine Acupuncturist 710 W. Princeton Street., Suite A, Orlando, FL 32804 2015-02-10
1164822359 Orlando Sleep Solutions, LLC Durable Medical Equipment & Medical Supplies 2921 N. Orange Ave, Orlando, FL 32804 2014-08-26
1780926741 Joseph Arturo Reza Student in an Organized Health Care Education/Training Program 2415 N Orange Ave #400, Orlando, FL 32804 2013-03-17
Find all providers in zip 32804

Taxonomy Information

Taxonomy Code 207RE0101X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Endocrinology, Diabetes & Metabolism

Taxonomy Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437425691 Vanaja Vijaya Ragavan Internal Medicine 12502 Lake Mary Jane Rd, Orlando, FL 32832 2012-03-31
1497988927 Steven Richard Smith Internal Medicine 301 E. Princeston St., Orlando, FL 32804-5546 2009-09-01
1104911452 Rita Y Rahbany Internal Medicine 9166 University Blvd, Orlando, FL 32817-1709 2006-10-04
1295849552 Tina Kaur Thethi Internal Medicine 2415 N Orange Ave Ste 502, Orlando, FL 32804-5503 2006-08-17
1316996325 Diabetes & Endocrine Center of Orlando, P.a. Internal Medicine 3113 Lawton Rd, Suite 100, Orlando, FL 32803-3531 2006-05-08
1558327973 Sowmya K Suryanarayanan Internal Medicine 9975 Tavistock Lakes Blvd Ste 300, Orlando, FL 32827-7665 2006-04-25
1083683106 Edwin N Lee Internal Medicine 7009 Dr Phillips Blvd, Suite 150, Orlando, FL 32819-5123 2006-03-14
1366415978 Orlando Diabetes and Endocrine Specialists Internal Medicine 6150 Metrowest Blvd, Suite 105, Orlando, FL 32835-3290 2006-02-13
1871598128 Henry Jackson Baskin Sr. Internal Medicine 2921 N Orange Ave, Orlando, FL 32804-4627 2005-06-14
1427656016 Orlando Endocrinology, LLC Internal Medicine 11616 Lake Underhill Rd Ste 205, Orlando, FL 32825-4466 2020-10-15
Find all providers in ORLANDO

Competitor

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City ORLANDO
Zip Code 32804

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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