MEDICARE: DONALD KLIPPENSTEIN MD

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	2085R0202X	Diagnostic Radiology Physician	ME103162	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508863879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD KLIPPENSTEIN MD

Provider Business Mailing Address
First Line	:	PO BOX 198441
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-8441
Country	:	US
Telephone Number	:	813-745-4673
Fax Number	:	813-449-8618

Provider Business Practice Location Address
First Line	:	12902 USF MAGNOLIA DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-9416
Country	:	US
Telephone Number	:	813-745-4673
Fax Number	:	813-449-8618

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	09/17/2025

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