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General NPI Number Information
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NPI Number | 1508245515
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Entity Type | Individual
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Provider Name | CAMERON KLUTH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2015
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 825 E OAK ST
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City | KISSIMMEE
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State | FL
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Zip | 34744-5838
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Country | US
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Telephone | 321-442-8009
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Fax | 321-442-8012
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Provider Business Mailing Address
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Address Line | PO BOX 420037
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City | KISSIMMEE
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State | FL
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Zip | 34742-0037
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Country | US
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Telephone | 321-442-8009
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Fax | 321-442-8012
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME149353
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 60947
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License Number State | TN
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