Individual
KENNETH DANIEL KRABACHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD # 100186, GAINESVILLE, FL 32610-1900
(352) 265-5911
(352) 265-5606
Mailing address
1600 SW ARCHER RD # 100186, GAINESVILLE, FL 32610-0183
(352) 265-5911
(352) 265-5606
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME129897
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021296800
—
FL
01
—
JA630Z
MEDICARE PTAN
—
Enumeration date
04/04/2014
Last updated
07/21/2022
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