Individual
CHARLES P KRONENTHAL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6279 N LECANTO HWY, BEVERLY HILLS, FL 34465-2503
(352) 522-0094
(352) 522-0098
Mailing address
14690 SPRING HILL DR STE 305, SPRING HILL, FL 34609-8102
(352) 277-5348
(352) 606-2857
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 9104143
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000694000
—
FL
01
—
59-3682760
TRI CARE
FL
Enumeration date
03/17/2006
Last updated
07/12/2019
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