Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME91756 | FL |
NPI | 1003836396 |
---|---|
Provider Name | Jason B Klapman |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-9416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 04/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
52210 | BLUE CROSS BLUE SHIELD (01) | FL |
H05641 | (02) | FL |