Individual ProviderCrystal WangHospitalistAllopathic & Osteopathic PhysiciansPractice Address820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205(904) 202-3860(904) 202-1032PECOS EnrollmentBased on the most recent information from CMS, provider Crystal Wang is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:21 AM.Profile DetailsProvider ID1144678327Provider TypeIndividualFull NameWang, CrystalTitleDr.CredentialD.O.GenderFemaleSole ProprietorNoEnumeration Date5/30/2016Last Updated7/10/2024Contact InformationPractice LocationPractice Address820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205Phone(904) 202-3860Fax(904) 202-3846Mailing LocationMailing AddressPO Box 746638, Atlanta, GA 30374-6638Phone(904) 202-1032Fax(904) 376-4107Provider TaxonomiesCodeDescriptionLicenseCode208M00000XPrimaryDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicenseOS17120FloridaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseOS17120Florida