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General NPI Number Information
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NPI Number | 1972895456
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Entity Type | Organization
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Legal Business Name | RONALD G KLUDO DO PA
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Dates
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Enumeration Date | 05/03/2011
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | 7653 LKAKE WORTH
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City | LAKE WORTH
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State | FL
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Zip | 33467
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Country | US
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Telephone | 561-434-9066
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Fax |
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Provider Business Mailing Address
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Address Line | 7653 LKAKE WORTH
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City | LAKE WORTH
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State | FL
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Zip | 33467
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Country | US
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Telephone | 561-434-9066
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Fax |
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Authorized Official
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Title or Position | PHYSICAN
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Name | DR. RONALD G KLUDO
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Credential | D.O,
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Telephone | 561-434-9066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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