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General NPI Number Information
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NPI Number | 1407226277
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Entity Type | Organization
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Legal Business Name | KRYPTON MEDICAL LLC
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Dates
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Enumeration Date | 10/05/2015
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Last Update Date | 12/24/2021
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Provider Practice Location Address
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Address Line | 10771 SW 64TH ST
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City | MIAMI
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State | FL
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Zip | 33173-2022
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Country | US
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Telephone | 305-301-3693
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Fax | 305-553-5271
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Provider Business Mailing Address
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Address Line | 10771 SW 64TH ST
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City | MIAMI
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State | FL
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Zip | 33173-2022
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Country | US
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Telephone | 305-301-3693
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Fax | 305-553-5271
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | DAVID JOSE TRABANCO
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Credential | ARNP, AGNP, NP-C
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Telephone | 305-301-3693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | ARNP9337727
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | ARNP9337727
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP9337727
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License Number State | FL
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