Provider Demographics
NPI:1306861687
Name:KRAUT, ROBERT JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAY
Last Name:KRAUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4624 HALDER LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6435
Mailing Address - Country:US
Mailing Address - Phone:407-897-7470
Mailing Address - Fax:407-897-7473
Practice Address - Street 1:4624 HALDER LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6435
Practice Address - Country:US
Practice Address - Phone:407-897-7470
Practice Address - Fax:407-897-7473
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76040207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255216700Medicaid
FL5320680OtherAETNA
FLP00119566OtherRAIL ROAD MEDICARE
FL43901OtherBLUE CROSS & BLUE SHIELD
FL43901OtherBLUE CROSS & BLUE SHIELD
FL5320680OtherAETNA