Elizabeth Krochak MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME46477 Issued in FL

Legal business name

ELIZABETH KROCHAK MD PA

Practice address

106 N Old Kings Rd
Suite B
Ormond Beach, FL 32174

Phone

(386) 673-5561

Fax

(386) 672-3192

NPI assigned

Aug 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Elizabeth Marie Krochak, MD

Title

Medical Doctor

Phone

(386) 673-5361

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306857776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N OLD KINGS RD",
            "address_2": "SUITE B",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-673-5561",
            "fax_number": "386-672-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N OLD KINGS RD",
            "address_2": "SUITE B",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-673-5561",
            "fax_number": "386-672-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH KROCHAK MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KROCHAK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "386-673-5361",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME46477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.