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General NPI Number Information
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NPI Number | 1235427774
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Entity Type | Organization
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Legal Business Name | STUART B. KROST M.D. P.A.
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 9220 SW 72ND ST SUITE 106
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City | MIAMI
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State | FL
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Zip | 33173-3259
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Country | US
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Telephone | 305-722-9954
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Fax | 561-296-2221
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Provider Business Mailing Address
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Address Line | 3618 LANTANA RD SUITE 201
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City | LAKE WORTH
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State | FL
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Zip | 33462-2246
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Country | US
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Telephone | 561-296-2220
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Fax | 561-296-2221
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Authorized Official
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Title or Position | OWNER
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Name | STUART B KROST
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Credential | MD
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Telephone | 561-290-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9103862
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9103888
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0061951
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License Number State | FL
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