Provider Demographics
NPI:1407226277
Name:KRYPTON MEDICAL LLC
Entity Type:Organization
Organization Name:KRYPTON MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:TRABANCO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, AGNP, NP-C
Authorized Official - Phone:305-301-3693
Mailing Address - Street 1:10771 SW 64TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2022
Mailing Address - Country:US
Mailing Address - Phone:305-301-3693
Mailing Address - Fax:305-553-5271
Practice Address - Street 1:10771 SW 64TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2022
Practice Address - Country:US
Practice Address - Phone:305-301-3693
Practice Address - Fax:305-553-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2021-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9337727363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty