Provider Demographics
NPI:1962423327
Name:KRAMER, BARRY L (MD)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:L
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 N MILLS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4599
Mailing Address - Country:US
Mailing Address - Phone:407-841-7151
Mailing Address - Fax:407-425-2768
Practice Address - Street 1:1745 N MILLS AVE STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4599
Practice Address - Country:US
Practice Address - Phone:407-841-7151
Practice Address - Fax:407-425-2768
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-0054751207RC0000X
NC2007-00323207RC0000X
FLME0054751207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC145V1OtherBCBS-NC
1937719004OtherCIGNA
FL254736800Medicaid
592171328-001OtherCHAMPUS/TRICARE
P00416538OtherRAILROAD MEDICARE
SCQ0032DMedicaid
060046816OtherRAILROAD MEDICARE
FL14692OtherBLUE SHIELD
210450OtherWELLCARE
5231011OtherAETNA
6005750OtherGHI
NC5906501Medicaid
592171328-001OtherCHAMPUS/TRICARE
FL14692OtherBLUE SHIELD
NC145V1OtherBCBS-NC
6005750OtherGHI