Healthcare Provider Details

I. General information

NPI: 1659061596
Provider Name (Legal Business Name): ELISABETH RYMER KRUEGER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 STURTEVANT ST
ORLANDO FL
32806-2022
US

IV. Provider business mailing address

50 STURTEVANT ST
ORLANDO FL
32806-2022
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-5098
  • Fax: 407-649-8869
Mailing address:
  • Phone: 321-841-1681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY-2732
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: