MEDICARE: WARREN MITCHELL KRANTZ M.D.

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	208000000X	Pediatrics Physician	53935	FL

General Provider Information

NPI Number	:	1588708507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WARREN MITCHELL KRANTZ M.D.

Provider Business Mailing Address
First Line	:	11609 PALMETTO WAY
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33026-1231
Country	:	US
Telephone Number	:	786-514-8654
Fax Number	:

Provider Business Practice Location Address
First Line	:	19030 NE 29TH AVE
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33180-2823
Country	:	US
Telephone Number	:	305-932-5533
Fax Number	:

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

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	07/08/2007

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