Provider Demographics
NPI:1427130020
Name:KRONGRAD, ARNON (MD)
Entity type:Individual
Prefix:DR
First Name:ARNON
Middle Name:
Last Name:KRONGRAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20900 NE 30TH AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2100
Mailing Address - Country:US
Mailing Address - Phone:305-936-0474
Mailing Address - Fax:305-936-0498
Practice Address - Street 1:20900 NE 30TH AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2100
Practice Address - Country:US
Practice Address - Phone:305-936-0474
Practice Address - Fax:305-936-0498
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0062761208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH01706Medicare UPIN
FL46908Medicare ID - Type Unspecified