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General NPI Number Information
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NPI Number | 1386088276
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Entity Type | Individual
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Provider Name | MICAH MAE KRAMER PA 9107084
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Gender | Female
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 3319 S STATE ROAD 7 STE. 313
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City | WELLINGTON
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State | FL
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Zip | 33449-8184
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Country | US
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Telephone | 561-932-0699
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Fax | 561-721-8659
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Provider Business Mailing Address
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Address Line | 3319 S STATE ROAD 7 STE. 314
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City | WELLINGTON
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State | FL
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Zip | 33449-8184
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Country | US
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Telephone | 561-932-0699
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Fax | 561-721-8659
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 9107084
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License Number State | FL
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