MR. ERIC SCOTT KLUG (NPI# 1124105259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124105259 |
| Entity Type | Individual |
| Full Name | MR. ERIC SCOTT KLUG |
| Credential | P.A. |
| Practice Address |
4600 N Habana Ave Ste 27 Tampa FL 33614-7112 |
| Mailing Address |
Po Box 271489 Tampa FL 33688-1489 |
| Practice Telephone | 8138908004 |
| Practice Fax Number | 8132909691 |
| Mailing Telephone | 8138764900 |
| Mailing Fax Number | 8138764997 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9103515 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 292475700 | 05 | |
| FL | MEDICARE RAILROAD | P00604695 | 01 |
| Street Address |
4600 N HABANA AVE STE 27 |
| City | TAMPA |
| State | FL |
| Zip Code | 33614-7112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578559753 | Leopoldo Grauer Md Pa | Internal Medicine | 4600 N Habana Ave, Ste 29, Tampa, FL 33614-7166 | 2005-09-23 |
| 1053701359 | Luis E. Kortright M.d. | Orthopaedic Surgery | 4600 N Habana Ave, Suite # 6, Tampa, FL 33614-7112 | 2015-01-26 |
| 1780922997 | Ruben J Perez-ramos | Internal Medicine | 4600 N Habana Ave, # 27, Tampa, FL 33614-7112 | 2013-01-23 |
| 1922342906 | Md and Wellness Center Inc | Clinic/Center | 4600 N Habana Ave, Suite 12, Tampa, FL 33614-7112 | 2012-11-15 |
| 1811275720 | Ramon Hugo Sanchez, M.d., Pa | Independent Medical Examiner | 4600 N Habana Ave, Suite 32, Tampa, FL 33614-7112 | 2011-07-26 |
| 1619268026 | Genesis Physicians Group LLC | Internal Medicine | 4600 N Habana Ave, #27, Tampa, FL 33614-7112 | 2011-04-20 |
| 1285930123 | Peggy Lynn Wallace | Nurse Practitioner | 4600 N Habana Ave, Suite 15, Tampa, FL 33614-7112 | 2011-02-09 |
| 1164728630 | G. E. Vega, M. D., P. A. | Specialist | 4600 N Habana Ave, Suite 33, Tampa, FL 33614-7112 | 2011-02-01 |
| 1174828313 | Dr Anthony A Fernandez Md Pa | Clinic/Center | 4600 N Habana Ave, Ste 16, Tampa, FL 33614-7112 | 2011-01-19 |
| 1114231347 | Joseph G Sinkovics Md Pa | Clinic/Center | 4600 N Habana Ave, Suite 9, Tampa, FL 33614-7112 | 2010-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733082 | Robin Rollena Stewart | Home Health | 9537 Lazy Lane, Apt 302, Tampa, FL 33614 | 2020-09-08 |
| 1346885761 | David Joseph Page | Nurse Practitioner | St. Joseph's Behavioral Health Center, 4918 N. Habana Ave, Tampa, FL 33614 | 2019-11-08 |
| 1134687411 | Ramon Chang Adult Family Care Home LLC | Custodial Care Facility | 2607 W Humphrey St, Tampa, FL 33614 | 2019-03-06 |
| 1134600612 | Senior Point Assisted Living Facility, LLC | Assisted Living Facility | 2940 W Hillsborough Ave, Tampa, FL 33614 | 2018-08-23 |
| 1306361266 | Larry Valdes | Assisted Living Facility | 4402 W Minnehaha St, Tampa, FL 33614 | 2017-08-11 |
| 1982128062 | Jaime F Casellas Md Corp | Internal Medicine | 4600 N Habana Ave Suit #13, Tampa, FL 33614 | 2017-07-31 |
| 1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
| 1750811857 | Syerita Nicole Morris | Counselor | 6800 N Dale Marby Hwy, Ste 164, Tampa, FL 33614 | 2017-06-13 |
| 1447786124 | Lisa Moy | Case Manager/Care Coordinator | 4001 W. Dr. Martin Luther King Jr. Blvd., Tampa, FL 33614 | 2017-05-02 |
| 1750813804 | Joshua Martin Good | Physical Therapy Assistant | 3363 W. Waters Avenue, Suite 700, Tampa, FL 33614 | 2017-03-29 |
| Find all providers in zip 33614 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336762046 | Samantha Martin | Physician Assistant | 12950 Race Track Rd Ste 106, Tampa, FL 33626-1304 | 2020-05-28 |
| 1124648159 | Christian Otero | Physician Assistant | 311 W Palm Ave, Tampa, FL 33602-2029 | 2020-04-20 |
| 1487219036 | Vanessa Natasha White | Physician Assistant | 10205 W Hillsborough Ave Ste B, Tampa, FL 33615-3671 | 2019-05-08 |
| 1518520873 | Zachary Luke Ulshafer | Physician Assistant | 12901 Bruce B Downs Blvd # 05, Tampa, FL 33612-4742 | 2019-04-22 |
| 1548756893 | Christopher Jacob Bordelon | Physician Assistant | 2550 W Dr Martin Luther King Jr Blvd Ste B, Tampa, FL 33607-6302 | 2018-07-10 |
| 1871033340 | Amanda Lins Chissell | Physician Assistant | 13801 Bruce B Downs Blvd Ste 231, Tampa, FL 33613-3946 | 2017-03-03 |
| 1669839767 | Barbara N Vargas | Physician Assistant | 12500 N Dale Mabry Hwy Ste A, Tampa, FL 33618-2809 | 2016-01-20 |
| 1215305776 | Amber Lubas | Physician Assistant | 401 N Rome Ave, Apt: 4314, Tampa, FL 33606-0009 | 2015-09-14 |
| 1972988467 | Karla Michelle Mincone | Physician Assistant | 3040 W Cypress St # 103, Tampa, FL 33609-1615 | 2015-07-25 |
| 1326441767 | Brigett Brandjes | Physician Assistant | 2902 Usf Magnolia Drive, Tampa, FL 33612 | 2014-09-30 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.