Provider Demographics
NPI:1376534057
Name:KRANC, MARK A T (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A T
Last Name:KRANC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 741087
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1087
Mailing Address - Country:US
Mailing Address - Phone:352-597-7083
Mailing Address - Fax:352-597-3095
Practice Address - Street 1:11375 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613
Practice Address - Country:US
Practice Address - Phone:352-597-7083
Practice Address - Fax:352-597-3095
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2018-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME130911207ZP0102X
NH9559207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology