Organization
FAMILY PSYCHIATRY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIANNE G KROUK DO (DIRECTOR OF CORPORATION)
(239) 220-3543
Entity
Organization
Contact information
Practice address
12641 WORLD PLAZA LN, SUITE 56, FORT MYERS, FL 33907-3990
(239) 220-3543
Mailing address
5031 HARBORTOWN LN, FORT MYERS, FL 33919-4650
(239) 220-3543
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
OS10199
FL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
OS10199
FL
Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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