Healthcare Provider Details

I. General information

NPI: 1821037193
Provider Name (Legal Business Name): RICHARD S KRUGMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8609 FOREST CITY RD
ORLANDO FL
32810
US

IV. Provider business mailing address

100 S VIRGINIA AVE UNIT 403
WINTER PARK FL
32789-4344
US

V. Phone/Fax

Practice location:
  • Phone: 407-293-1790
  • Fax:
Mailing address:
  • Phone: 561-293-6137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME54446
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: