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General NPI Number Information
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NPI Number | 1245635630
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Entity Type | Organization
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Legal Business Name | KENNETH L. KRONBERG, M.D., P.A.
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 9417 W SAMPLE RD
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4102
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Country | US
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Telephone | 954-575-9710
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Fax | 954-575-9968
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Provider Business Mailing Address
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Address Line | 9417 W SAMPLE RD
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4102
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Country | US
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Telephone | 954-575-9710
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Fax | 954-575-9968
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Authorized Official
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Title or Position | OWNER
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Name | KENNETH LLOYD KRONBERG
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Credential | M.D.
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Telephone | 954-575-9710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 27724
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License Number State | FL
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