MEDICARE: MICHAEL P KLITENICK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME0031698	FL
2	208600000X	Surgery Physician	ME31698	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	93832	OTHER	FL	PROVIDER INDV. NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245332469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL P KLITENICK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 100707
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-0707
Country	:	US
Telephone Number	:	786-662-7980
Fax Number	:

Provider Business Practice Location Address
First Line	:	3136 NORTHSIDE DR UNIT D
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-8027
Country	:	US
Telephone Number	:	305-271-9777
Fax Number	:	786-591-6191

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	05/14/2026

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