Individual
DR. PAIGE VANIER KREEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4369 TAMIAMI TRAIL, CHARLOTTE HARBOR, FL 33980-2118
(941) 629-4888
(941) 629-5935
Mailing address
4369 TAMIAMI TRAIL, CHARLOTTE HARBOR, FL 33980-2118
(941) 629-4888
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME42565
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010065128
RAILROAD MEDICARE
FL
01
—
651117653
TAX IDENTIFICATION NUMBER
FL
01
—
96292
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
06/08/2006
Last updated
06/01/2015
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