Healthcare Provider Details

I. General information

NPI: 1457763096
Provider Name (Legal Business Name): DARREN KLAWINSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 CHILDRENS WAY
JACKSONVILLE FL
32207-8426
US

IV. Provider business mailing address

807 CHILDRENS WAY
JACKSONVILLE FL
32207-8426
US

V. Phone/Fax

Practice location:
  • Phone: 904-697-3600
  • Fax:
Mailing address:
  • Phone: 904-697-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME131091
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberME131091
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: