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NPI Code Detail

MEDICARE: MARK R KRAKOVITZ MD

MEDICARE: MARK R KRAKOVITZ 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
12085R0202XDiagnostic Radiology PhysicianMD033369EPA
22085R0202XDiagnostic Radiology Physician25MA05265300NJ
3207U00000XNuclear Medicine PhysicianMD033369EPA
4207U00000XNuclear Medicine Physician25MA05265300NJ
52085R0202XDiagnostic Radiology Physician12550ND
62085R0202XDiagnostic Radiology PhysicianME112875FL

General Provider Information

NPI Number : 1922046242
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK R KRAKOVITZ MD
Provider Business Mailing Address
First Line : 3265 NW 87TH AVE.
Second Line :
City : MIAMI
State : FL
Zip : 33172
Country : US
Telephone Number : 952-595-1301
Fax Number : 952-942-3361
Provider Business Practice Location Address
First Line : 1301 15TH AVE. W.
Second Line :
City : WILLISTON
State : ND
Zip : 58801-3821
Country : US
Telephone Number : 701-774-7435
Fax Number : 701-774-7479
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 11/13/2012

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