Healthcare Provider Details

I. General information

NPI: 1609875889
Provider Name (Legal Business Name): HARRY D KROP PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 NW 12TH AVE SUITE B
GAINESVILLE FL
32601-3032
US

IV. Provider business mailing address

1212 NW 12TH AVE SUITE B
GAINESVILLE FL
32601-3032
US

V. Phone/Fax

Practice location:
  • Phone: 352-372-6645
  • Fax: 352-373-1237
Mailing address:
  • Phone: 352-372-6645
  • Fax: 352-373-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY0002364
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: