MEDICARE: MR. RICHARD J KRAMER P.T

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT5627	FL

General Provider Information

NPI Number	:	1144523028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD J KRAMER P.T

Provider Business Mailing Address
First Line	:	4533 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6611
Country	:	US
Telephone Number	:	954-342-1177
Fax Number	:	954-510-0138

Provider Business Practice Location Address
First Line	:	4533 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6611
Country	:	US
Telephone Number	:	954-342-1177
Fax Number	:	954-510-0138

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2010
Last Update Date	:	04/20/2011

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