MEDICARE: MR. DAVID IVAN KRANSON CAP

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor	MH18062	FL

General Provider Information

NPI Number	:	1982990222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID IVAN KRANSON CAP

Provider Business Mailing Address
First Line	:	4140 NW 27TH LN STE F
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-6600
Country	:	US
Telephone Number	:	352-449-4024
Fax Number	:

Provider Business Practice Location Address
First Line	:	4140 NW 27TH LN STE F
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-6600
Country	:	US
Telephone Number	:	352-449-4024
Fax Number	:

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

Provider Enumeration Date	:	06/24/2011
Last Update Date	:	02/10/2023

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Directions to “ MR. DAVID IVAN KRANSON CAP” Practice Location

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