Healthcare Provider Details

I. General information

NPI: 1740062546
Provider Name (Legal Business Name): ALBERT J KLIMCZAK DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3461 BONITA BAY BLVD STE 101
BONITA SPRINGS FL
34134-4374
US

IV. Provider business mailing address

3785 FIELDSTONE BLVD APT 207
NAPLES FL
34109-0733
US

V. Phone/Fax

Practice location:
  • Phone: 239-676-2080
  • Fax:
Mailing address:
  • Phone: 239-919-2533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: