Provider Demographics
NPI:1669442968
Name:KRUMHOLTZ, SEBA LEE (MD)
Entity Type:Individual
Prefix:
First Name:SEBA
Middle Name:LEE
Last Name:KRUMHOLTZ
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1905 CLINT MOORE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2658
Mailing Address - Country:US
Mailing Address - Phone:561-994-5454
Mailing Address - Fax:
Practice Address - Street 1:1905 CLINT MOORE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2658
Practice Address - Country:US
Practice Address - Phone:561-994-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2008-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME56266207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08941OtherBCBS OF FL
P00413514OtherRAILROAD MEDICARE
FL08941OtherBCBS OF FL
FL08941XMedicare PIN