Provider Demographics
NPI:1114113537
Name:RICHARD A KRUMHOLZ MD PL LLC
Entity Type:Organization
Organization Name:RICHARD A KRUMHOLZ MD PL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:KRUMHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-927-1522
Mailing Address - Street 1:2344 BEE RIDGE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-6275
Mailing Address - Country:US
Mailing Address - Phone:941-927-1522
Mailing Address - Fax:941-922-3415
Practice Address - Street 1:2344 BEE RIDGE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6275
Practice Address - Country:US
Practice Address - Phone:941-927-1522
Practice Address - Fax:941-922-3415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53670207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY52582Medicare UPIN
FLK9574Medicare PIN