Provider Demographics
NPI:1780672527
Name:KRAMMER, JUDITH (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:KRAMMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 SAWGRASS CORPORATE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2826
Mailing Address - Country:US
Mailing Address - Phone:800-243-3839
Mailing Address - Fax:855-527-5510
Practice Address - Street 1:8270 COLLEGE PKWY
Practice Address - Street 2:SUITE 205
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4102
Practice Address - Country:US
Practice Address - Phone:239-333-3826
Practice Address - Fax:855-527-5510
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057937207V00000X
FLME57937207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063942700Medicaid
FL639427000Medicaid
FL639427000Medicaid