Healthcare Provider Details

I. General information

NPI: 1306167614
Provider Name (Legal Business Name): MICHAEL KRANTZOW D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9970 CENTRAL PARK BLVD N SUITE 300
BOCA RATON FL
33428-2231
US

IV. Provider business mailing address

9970 CENTRAL PARK BLVD N SUITE 300
BOCA RATON FL
33428-2231
US

V. Phone/Fax

Practice location:
  • Phone: 561-488-2200
  • Fax:
Mailing address:
  • Phone: 561-488-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOS13850
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: