=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992876197
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RIMA KRISTINA KLIMAS O.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2006
-----------------------------------------------------
Last Update Date | 09/13/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 260 LOOKOUT PL STE 105
-----------------------------------------------------
City | MAITLAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32751-4485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-647-7227
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1911 N MILLS AVE
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32803-1407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-893-8200
-----------------------------------------------------
Fax | 407-893-8210
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | OPC3597
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------