Provider Demographics
NPI:1700079043
Name:JAMES N KRAUT PSY D PA
Entity type:Organization
Organization Name:JAMES N KRAUT PSY D PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:N
Authorized Official - Last Name:KRAUT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-757-1400
Mailing Address - Street 1:3111 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 429
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5086
Mailing Address - Country:US
Mailing Address - Phone:954-757-1400
Mailing Address - Fax:954-757-3232
Practice Address - Street 1:3111 N UNIVERSITY DR
Practice Address - Street 2:SUITE 429
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5086
Practice Address - Country:US
Practice Address - Phone:954-757-1400
Practice Address - Fax:954-757-3232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4990103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAG186Medicare PIN
FL59472XMedicare PIN
FL59472Medicare PIN