Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO2052 | FL |
NPI | 1003890054 |
---|---|
Provider Name | Gordon J Kleinpell |
First Address | Ft Myers, FL 33919-4888 |
Second Address | Lehigh Acres, FL 33971-1567 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 13/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1274280001 | MEDICARE DME (01) | FL |
4800015521 | RAILROAD MEDICARE (01) | FL |
U08595 | (02) |