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Individual

MR. ERIC SCOTT KLUG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
4620 N HABANA AVE STE 101, TAMPA, FL 33614-7107
(813) 875-9362
(813) 876-7055
Mailing address
4620 N HABANA AVE STE 101, TAMPA, FL 33614-7107
(813) 875-9362
(813) 876-7055

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9103515
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
292475700
FL
01
P00604695
MEDICARE RAILROAD
FL
Enumeration date
11/01/2006
Last updated
12/14/2021
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