Provider Demographics
NPI:1174519987
Name:KRAINSON, JAMES PHILIP (MDFCCP)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILIP
Last Name:KRAINSON
Suffix:
Gender:M
Credentials:MDFCCP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12600 SW 120TH ST
Mailing Address - Street 2:SUITE 117
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-9066
Mailing Address - Country:US
Mailing Address - Phone:305-255-0777
Mailing Address - Fax:305-255-1067
Practice Address - Street 1:12600 SW 120TH ST
Practice Address - Street 2:SUITE 117
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-9066
Practice Address - Country:US
Practice Address - Phone:305-255-0777
Practice Address - Fax:305-255-7447
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME32820207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL065462100Medicaid
FLD63580Medicare UPIN
FL065462100Medicaid