Provider Demographics
NPI:1861127656
Name:KRUM, ARIANA (MBA)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:
Last Name:KRUM
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 SE BREVARD AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7206
Mailing Address - Country:US
Mailing Address - Phone:561-951-4267
Mailing Address - Fax:
Practice Address - Street 1:2737 SE BREVARD AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7206
Practice Address - Country:US
Practice Address - Phone:561-951-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator