Provider Demographics
NPI:1023626561
Name:CREDENTIALING CONSULTANTS OF FL LLC
Entity type:Organization
Organization Name:CREDENTIALING CONSULTANTS OF FL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-710-7747
Mailing Address - Street 1:1003 ALABASTER CV
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-3607
Mailing Address - Country:US
Mailing Address - Phone:321-710-7747
Mailing Address - Fax:877-797-2707
Practice Address - Street 1:1003 ALABASTER CV
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-3607
Practice Address - Country:US
Practice Address - Phone:321-710-7747
Practice Address - Fax:877-797-2707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty