Provider Demographics
NPI:1861434664
Name:KRONK, PATRICIA A (ARNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:KRONK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24441 AMBERLEAF CT
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-2106
Mailing Address - Country:US
Mailing Address - Phone:352-365-6944
Mailing Address - Fax:
Practice Address - Street 1:2000 PREVATT ST
Practice Address - Street 2:SUITE B3
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726
Practice Address - Country:US
Practice Address - Phone:321-273-0301
Practice Address - Fax:407-668-6658
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP858942363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E6765Medicare ID - Type Unspecified
FLP48646Medicare UPIN