Provider Demographics
NPI:1255428090
Name:KRUGER, GINA M
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:M
Last Name:KRUGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 NW 8TH CT
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445
Mailing Address - Country:US
Mailing Address - Phone:561-496-4141
Mailing Address - Fax:
Practice Address - Street 1:14595 MILITARY TRL
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-3730
Practice Address - Country:US
Practice Address - Phone:561-637-2363
Practice Address - Fax:561-637-2876
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2501-0103-0351-549183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician