MEDICARE: MS. KIMBERLY G KRAFT PT CHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT40132	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	QY639	OTHER	FL	MEDICARE

General Provider Information

NPI Number	:	1013977412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY G KRAFT PT CHT

Provider Business Mailing Address
First Line	:	8000 SR 64 E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34212-7703
Country	:	US
Telephone Number	:	941-792-1404
Fax Number	:	941-761-0712

Provider Business Practice Location Address
First Line	:	8000 SR 64 E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34212-7703
Country	:	US
Telephone Number	:	941-792-1404
Fax Number	:	941-761-0712

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	09/23/2024

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