MEDICARE: RONICA M KLUGE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	ME24849	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336147636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONICA M KLUGE MD

Provider Business Mailing Address
First Line	:	PO BOX 7006
Second Line	:
City	:	FT MYERS
State	:	FL
Zip	:	33911-7006
Country	:	US
Telephone Number	:	239-948-3761
Fax Number	:	239-931-3454

Provider Business Practice Location Address
First Line	:	24600 S TAMIAMI TRL
Second Line	:	SUITE 400
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7022
Country	:	US
Telephone Number	:	239-948-3761
Fax Number	:	239-931-3454

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	07/06/2012

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