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Individual

BORIS V KLOPUKH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
21110 BISCAYNE BLVD, SUITE 201, AVENTURA, FL 33180-1227
(305) 534-4747
(305) 937-7726
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME82314
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
042600
NHP
FL
01
0521542
CIGNA
FL
01
1047823
CAREPLUS
FL
01
11660
DIMENSION
FL
01
14VW0
BCBS
FL
01
1755252
CIGNA
FL
01
244429
AVMED
FL
01
5911548
AETNA
FL
01
61443
BCBS
FL
01
62972
BLUE CROSS BLUE SHIELD
FL
01
P01392104
RR MEDICARE
FL
01
P01730006
SIMPLY HEALTHCARE
FL
01
P1017463
FREEDOM
FL
01
P956279
OPTIMUM
FL
Enumeration date
05/01/2006
Last updated
10/06/2016
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