MEDICARE: DR. BARRY A KLIGERMAN

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	1223P0300X	Periodontics	DN6029	FL

General Provider Information

NPI Number	:	1275648222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY A KLIGERMAN

Provider Business Mailing Address
First Line	:	2480 EAST COMMERCIAL BOULEVARD
Second Line	:	PENTHOUSE SUITE
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308
Country	:	US
Telephone Number	:	954-771-9090
Fax Number	:	954-776-9909

Provider Business Practice Location Address
First Line	:	2480 EAST COMMERCIAL BOULEVARD
Second Line	:	PENTHOUSE SUITE
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308
Country	:	US
Telephone Number	:	954-771-9090
Fax Number	:	954-776-9909

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/08/2007

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