MEDICARE: DR. BRIAN K KRITCHMAN MD

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	207W00000X	Ophthalmology Physician	ME111441	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	4072023	OTHER	AETNA
2	917287	OTHER	BLOCK VISION
3	0800011	OTHER	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1437151065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN K KRITCHMAN MD

Provider Business Mailing Address
First Line	:	8292 EMERALD AVE
Second Line	:
City	:	PARKLAND
State	:	FL
Zip	:	33076-4430
Country	:	US
Telephone Number	:	502-552-8581
Fax Number	:	561-322-3589

Provider Business Practice Location Address
First Line	:	8292 EMERALD AVE
Second Line	:
City	:	PARKLAND
State	:	FL
Zip	:	33076-4430
Country	:	US
Telephone Number	:	502-552-8581
Fax Number	:	561-322-3589

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	11/04/2016

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