Marianne G. Krouk, DO

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

OS10199 Issued in FL

Practice address

5294 Summerlin Commons Way
Suite 1201
Fort Myers, FL 33907-2164

Phone

(239) 362-1339

Fax

(239) 362-1340

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Psychiatry, Inc.

  • Child & Adolescent Psychiatry Physician
  • Fort Myers, FL
  • NPI 1134419872
  NPD (past) Authorized official
• Parakleseos

  • Psychologist
  • Beaver, PA
  • NPI 1033257290
  NPD (past)
• Parakleseos

  • Mental Health Counselor
  • Beaver, PA
  • NPI 1952528051
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1881800902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5031 HARBORTOWN LANE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194650",
            "telephone_number": "239-362-1339",
            "fax_number": "239-362-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5294 SUMMERLIN COMMONS WAY",
            "address_2": "SUITE 1201",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072164",
            "telephone_number": "239-362-1339",
            "fax_number": "239-362-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROUK",
        "first_name": "MARIANNE",
        "middle_name": "G.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "OS10199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "414623",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279276100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Lynn Krispinsky, RN, BSN, CDE
• Brian A Krivisky, MD
• Anna Krizan Fano, DMD
• Barbara Jean Kropacek, R.D., L.D.N.
• Kayla R Kroschel, CRNA
• Norman Kruedelbach, PHD
• Loren Krumbholz, CRNA
• Antoinette Kruse, MSW
• Krushen Inc
• Krysalis

• Child & Adolescent Psychiatry Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Child & Adolescent Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.