Healthcare Provider Details

I. General information

NPI: 1629092234
Provider Name (Legal Business Name): DAVID KRAMER MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 FISHERMAN ST
OPA LOCKA FL
33054-3509
US

IV. Provider business mailing address

870 FISHERMAN STREET
OPA-LOCKA FL
33054
US

V. Phone/Fax

Practice location:
  • Phone: 305-688-2519
  • Fax: 305-688-2785
Mailing address:
  • Phone: 305-688-2519
  • Fax: 305-688-2785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberME0007088
License Number StateFL

VIII. Authorized Official

Name: MRS. DEBORAH JOHNSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-688-2519