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Contact Information

LARRY V CRISCO, MD
3901 UNIVERSITY BLVD S
SUITE 221
JACKSONVILLE, FL32216-4392
 Phone: 904-423-0010
 Fax: 904-423-0012
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Cardiology

207RI0011X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Nuclear Cardiology

207UN0901X 36 Physician/Nuclear Medicine
 

Nuclear Imaging & Therapy

207UN0902X 36 Physician/Nuclear Medicine
Indicates primary specialty

NPI Profile & details for LARRY V CRISCO · (Male)

NPI Number 1952395782
Status Active
Credentials MD
Entity Individual
Enumeration date 09/08/2005
Last updated 08/30/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME115672
  • GA License # 038457
  • GA License # 38457
  • GA Medicaid 000777686G
  • Other 1952395782 NPI
  • GA Other 58-1624987 TAX ID#
Hospital affiliation(s)
  • FLAGLER HOSPITAL - (Acute Care)
    400 HEALTH PARK BLVD
    SAINT AUGUSTINE, FL 32086
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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