MEDICARE: DR. JESSE LENEE KLUS PHARMD

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	1835P0200X	Pediatric Pharmacist	PS68929	FL

General Provider Information

NPI Number	:	1639007768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSE LENEE KLUS PHARMD

Provider Business Mailing Address
First Line	:	501 6TH AVE S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4634
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 6TH AVE S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4634
Country	:	US
Telephone Number	:	727-746-2784
Fax Number	:

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

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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