Provider Demographics
NPI:1437305307
Name:KRAMER, DORIAN GOLAN (LAC)
Entity Type:Individual
Prefix:MR
First Name:DORIAN
Middle Name:GOLAN
Last Name:KRAMER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 NW 107TH AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2746
Mailing Address - Country:US
Mailing Address - Phone:813-648-6684
Mailing Address - Fax:
Practice Address - Street 1:6245 66TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-5025
Practice Address - Country:US
Practice Address - Phone:727-873-3891
Practice Address - Fax:603-356-4118
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH116171100000X
FL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturist