Healthcare Provider Details

I. General information

NPI: 1073618120
Provider Name (Legal Business Name): EDUARDO KRAJEWSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 12/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7765 SW 87TH AVE SUITE 212A
MIAMI FL
33173-2596
US

IV. Provider business mailing address

7765 SW 87TH AVE SUITE 212A
MIAMI FL
33173-2596
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-3080
  • Fax: 305-596-3073
Mailing address:
  • Phone: 305-596-3080
  • Fax: 305-596-3073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberME93035
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: