STUART B KROST MD PA
Medical Practice at Lantana Rd, Lake Worth, FL

License number
Florida ME6195
Category
Medical Practice
Type
Specialist
License number
Florida PA9103888
Category
Nursing
Type
Medical
License number
Florida PA9103862
Category
Nursing
Type
Medical
Owner
Name: STUART B KROST M.D.
Title: OWNER
Phone: (561) 296-2220
Address
Address
3618 Lantana Rd, Lake Worth, FL 33462
National Provider ID: 1295922573
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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STUART B. KROST, M.D., PA

Lake Worth, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
CANCEL ADM DISS/REV
Registration:
Nov 20, 2000
Inactive since:
Dec 8, 2009
Phone:
(561) 296-2220 (Phone)
Addresses:
3618 Lantana Rd 201, Lake Worth, FL 33462 (Physical)
3618 Lantana Rd, Lake Worth, FL 33462
State ID:
P00000107972
Business type:
Florida Profit Corporation
President, Director:
Stuart B Krost (President, Director), 10394 Ln Reina Rd, Delray Beach, FL 33446 (Physical)
Agent:
Stuart Krost,3618 Lantana Rd, Lake Worth, FL 33462 (Physical)
EIN:
52-2277463

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