Healthcare Provider Details

I. General information

NPI: 1003249301
Provider Name (Legal Business Name): CALVIN C. KROM III D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2013
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 LINTON BLVD
DELRAY BEACH FL
33444-8149
US

IV. Provider business mailing address

601 LINTON BLVD
DELRAY BEACH FL
33444-8149
US

V. Phone/Fax

Practice location:
  • Phone: 561-276-2270
  • Fax:
Mailing address:
  • Phone: 561-276-2270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number293148
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number293148
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License NumberOS15744
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number293148
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS15744
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: