Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | OS4739 | FL |
Y | 207X00000X | Orthopaedic Surgeon | OS4739 | FL |
NPI | 1770582355 |
---|---|
Provider Name | Frederick J Mcclimans |
First Address | Tampa, FL 33618-3505 |
Second Address | Tampa, FL 33618-3505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 14/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D27404 | (02) | FL |