Individual
EVELYN A. KLUKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5153 NORTH 9TH AVE., NEMOURS CHILDREN'S CLINIC, PENSACOLA, PENSACOLA, FL 32504-8785
(850) 505-4700
(850) 505-4714
Mailing address
P.O. BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(407) 650-7129
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
17700
LA
207YP0228X
Pediatric Otolaryngology Physician
Primary
ME113095
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1385808
—
LA
Enumeration date
07/23/2006
Last updated
06/21/2012
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