Healthcare Provider Details

I. General information

NPI: 1043293335
Provider Name (Legal Business Name): PATRICK J KLEMAWESCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6294 - 1ST AVE N ALLERGY ASSOCIATES
ST. PETERSBURG FL
33710
US

IV. Provider business mailing address

6294 1 AVE N
ST. PETERSBURG FL
33710-8414
US

V. Phone/Fax

Practice location:
  • Phone: 727-345-1900
  • Fax: 727-347-5273
Mailing address:
  • Phone: 727-345-1900
  • Fax: 727-347-5273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberME93707
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: