Provider Demographics
NPI:1902351307
Name:DR KAREN E. KRUGER, PH D, LLC
Entity Type:Organization
Organization Name:DR KAREN E. KRUGER, PH D, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALEST/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIEANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DELOMBA
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:239-571-2578
Mailing Address - Street 1:9180 GALLERIA CT
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-4384
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2905 INLET COVE LN W
Practice Address - Street 2:SUITE 300
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-7539
Practice Address - Country:US
Practice Address - Phone:239-571-2578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8414103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01264499OtherRAILROAD MEDICARE
FL593N0OtherBCBS OF FL