MEDICARE: WILLIAM JOHN KRANTZ P.A.

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	363AM0700X	Medical Physician Assistant	PA9104738	FL

General Provider Information

NPI Number	:	1255567079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM JOHN KRANTZ P.A.

Provider Business Mailing Address
First Line	:	7875 W COMMERCIAL BLVD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33351-4353
Country	:	US
Telephone Number	:	954-726-0099
Fax Number	:	954-726-0047

Provider Business Practice Location Address
First Line	:	871 W OAKLAND PARK BLVD
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33311-1731
Country	:	US
Telephone Number	:	954-567-7141
Fax Number	:	954-565-5624

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

Provider Enumeration Date	:	06/08/2009
Last Update Date	:	03/24/2016

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