Provider Demographics
NPI:1255567079
Name:KRANTZ, WILLIAM JOHN (PA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOHN
Last Name:KRANTZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:7875 W COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4353
Mailing Address - Country:US
Mailing Address - Phone:954-726-0099
Mailing Address - Fax:954-726-0047
Practice Address - Street 1:871 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-1731
Practice Address - Country:US
Practice Address - Phone:954-567-7141
Practice Address - Fax:954-565-5624
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2016-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9104738363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical