Individual
CLAUDIA I KLENCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13241 BARTRAM PARK BLVD, SUITE 209, JACKSONVILLE, FL 32258-5212
(904) 242-4220
(904) 551-1502
Mailing address
13241 BARTRAM PARK BLVD, SUITE 209, JACKSONVILLE, FL 32258-5212
(904) 242-4220
(904) 551-1502
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
056581
GA
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
ME99572
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279578700
—
FL
05
—
854962086A
—
GA
05
—
854962086B
—
GA
Enumeration date
02/20/2006
Last updated
03/28/2014
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