Provider Demographics
NPI:1598592875
Name:CRAVEN, CHRISTIAN ANTHONY (HAS)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:ANTHONY
Last Name:CRAVEN
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 N COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-5363
Mailing Address - Country:US
Mailing Address - Phone:352-949-9662
Mailing Address - Fax:
Practice Address - Street 1:5699 S SUNCOAST BLVD
Practice Address - Street 2:
Practice Address - City:HOMOSASSA
Practice Address - State:FL
Practice Address - Zip Code:34446-2605
Practice Address - Country:US
Practice Address - Phone:352-621-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5836237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist