Individual provider Active NPI

Crystal Pawula, APRN

  • Gerontology Nurse Practitioner
  • North Venice, FL
National Provider Identifier
1184092546
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN9440414 Issued in FL
Practice address
5500 Pinebrook Rd Ste 202
North Venice, FL 34275-3678
Phone
(941) 408-0500
Fax
(941) 496-8558
NPI assigned
Sep 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN9440414 FL Primary

Addresses

Primary practice location

5500 Pinebrook Rd Ste 202
North Venice, FL 34275-3678

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170322001782 FL Practitioner - Nurse Practitioner 2769791540 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9440414FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Nurse Practitioner CurrentSince Nov 28, 2022 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Mar 10, 2025 Accepting new patients

Locations

200 Healthcare Way
Unit 103
North Venice, FL 34275
Phone (941) 261-0160

5500 Pinebrook Rd
Ste 202
North Venice, FL 34275
Phone (941) 408-0500

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

836 Sunset Lake Blvd
Ste 102
Venice, FL 34292
Phone (941) 497-1771

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1184092546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 PINEBROOK RD STE 202",
            "city": "NORTH VENICE",
            "state": "FL",
            "postal_code": "342753678",
            "telephone_number": "941-408-0500",
            "fax_number": "941-496-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWULA",
        "first_name": "CRYSTAL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9440414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Venice, FL

Sources for this page

Verify at the official NPI Registry.