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Individual

DENISE L KLEMCZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1160 CYPRESS GLEN CIR, KISSIMMEE, FL 34741-7560
(407) 518-1993
(407) 518-9056
Mailing address
1160 CYPRESS GLEN CIR, KISSIMMEE, FL 34741-7560
(407) 518-1993
(407) 518-9056

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036118539
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
OS12104
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009224600
FL
01
036118539
ILLINOIS LICENSE
IL
05
036118539
IL
Enumeration date
06/08/2007
Last updated
08/22/2013
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