Healthcare Provider Details
I. General information
NPI: 1134584147
Provider Name (Legal Business Name): ROBERT D. KLAUSNER, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/17/2015
Last Update Date: 08/18/2024
Certification Date: 08/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26800 S TAMIAMI TRL STE 360
BONITA SPRINGS FL
34134-4355
US
IV. Provider business mailing address
2007 IMPERIAL GOLF COURSE BLVD
NAPLES FL
34110-1068
US
V. Phone/Fax
- Phone: 239-498-4968
- Fax: 239-498-0149
- Phone: 239-498-4968
- Fax: 239-498-0149
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207YS0123X |
| Taxonomy | Facial Plastic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
D.
KLAUSNER
Title or Position: PRESIDENT
Credential: MD
Phone: 239-498-4968