Healthcare Provider Details

I. General information

NPI: 1942113261
Provider Name (Legal Business Name): RICARDO SEBASTIAN KLUGER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1897 SW 154TH AVE
MIRAMAR FL
33027-4389
US

IV. Provider business mailing address

1897 SW 154TH AVE
MIRAMAR FL
33027-4389
US

V. Phone/Fax

Practice location:
  • Phone: 954-604-9221
  • Fax:
Mailing address:
  • Phone: 954-604-9221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT45135
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: