Provider Demographics
NPI:1770518078
Name:KRAHL, DEBORAH JO (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JO
Last Name:KRAHL
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 1:10912 NW 41ST DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-7762
Mailing Address - Country:US
Mailing Address - Phone:952-250-8698
Mailing Address - Fax:
Practice Address - Street 1:10912 NW 41ST DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-7762
Practice Address - Country:US
Practice Address - Phone:952-250-8698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN38777207V00000X
FLME151817207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN647014900Medicaid
MN647014900Medicaid