Provider Demographics
NPI:1558557520
Name:STUART B. KROST M.D.P.A.
Entity Type:Organization
Organization Name:STUART B. KROST M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:B
Authorized Official - Last Name:KROST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-296-2220
Mailing Address - Street 1:3618 LANTANA RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33462-2246
Mailing Address - Country:US
Mailing Address - Phone:561-296-2220
Mailing Address - Fax:561-296-1022
Practice Address - Street 1:875 MILITARY TRL
Practice Address - Street 2:SUITE 105
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5700
Practice Address - Country:US
Practice Address - Phone:561-768-0050
Practice Address - Fax:561-768-0059
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STUART B. KROST M.D.P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-24
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61951261QM1300X
FLPA9103862363AM0700X
FLPA9103888363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14950BMedicare UPIN