Healthcare Provider Details
I. General information
NPI: 1194809152
Provider Name (Legal Business Name): ENID KLAUBER-CHOEPHEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/25/2006
Last Update Date: 08/04/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
214 MORRISON RD SUITE 104
BRANDON FL
33511
US
IV. Provider business mailing address
214 MORRISON RD SUITE 104
BRANDON FL
33511-4849
US
V. Phone/Fax
- Phone: 813-681-6474
- Fax: 813-681-9092
- Phone: 813-681-6474
- Fax: 813-681-9092
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | ME88375 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: