Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | ME93707 | FL |
NPI | 1043293335 |
---|---|
Provider Name | Dr. Patrick J Klemawesch |
First Address | St. Petersburg, FL 33710-8414 |
Second Address | St. Petersburg, FL 33710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 24/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002200500 | (05) | FL |