Provider Demographics
NPI:1902911415
Name:KROUSE, NEAL F (DO)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:F
Last Name:KROUSE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:2345 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1110
Mailing Address - Country:US
Mailing Address - Phone:954-418-9445
Mailing Address - Fax:954-418-9313
Practice Address - Street 1:2345 W HILLSBORO BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1110
Practice Address - Country:US
Practice Address - Phone:954-418-9445
Practice Address - Fax:954-418-9313
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2010-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS4449207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82574Medicare PIN
D27375Medicare UPIN