Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MEOOO7088 | FL |
NPI | 1235153537 |
---|---|
Provider Name | Dr. David Kramer |
First Address | Opa-Locka, FL 33054 |
Second Address | Opa-Locka, FL 33054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205312 | AVMED (01) | FL |
D86400 | (02) | FL |