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Individual

DR. JEFFREY ALAN KROTENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
305 WAYMONT CT, SUITE 111, LAKE MARY, FL 32746-3566
(407) 324-0405
(407) 324-0075
Mailing address
305 WAYMONT CT, SUITE 111, LAKE MARY, FL 32746-3566
(407) 324-0405
(407) 324-0075

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
OS0004985
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
056251300
FL
01
066470
VALUE OPTIONS
FL
01
121134400
DEPT OF LABOR
FL
01
19404
UNITED HEALTHCARE
FL
01
260017797
RAILROAD MEDICARE
FL
01
3196405002
GHI
FL
01
80108
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/23/2006
Last updated
02/20/2015
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