Individual
MARIANNE G. KROUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5294 SUMMERLIN COMMONS WAY, SUITE 1201, FORT MYERS, FL 33907-2164
(239) 362-1339
(239) 362-1340
Mailing address
5031 HARBORTOWN LANE, FORT MYERS, FL 33919-4650
(239) 362-1339
(239) 362-1340
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
OS10199
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279276100
—
FL
05
—
414623
—
PA
Enumeration date
05/15/2007
Last updated
07/17/2015
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