Individual
RICHARD KLEMENTAVICIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME77791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009984555
—
AL
05
—
256621400
—
FL
01
—
46336
BCBS
FL
01
—
59169917
BCBS
AL
01
—
P00134526
PALMETTO GBA-RR MEDICARE
—
Enumeration date
05/17/2006
Last updated
11/02/2010
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