Provider Demographics
NPI:1164703849
Name:WORLD TRAVEL HEALTH CARE (DBA)PASSPORT HEALTH
Entity Type:Organization
Organization Name:WORLD TRAVEL HEALTH CARE (DBA)PASSPORT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:KLUGE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-C
Authorized Official - Phone:561-361-7484
Mailing Address - Street 1:7700 CONGRESS AVENUE
Mailing Address - Street 2:SUITE 1102
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487
Mailing Address - Country:US
Mailing Address - Phone:561-361-7484
Mailing Address - Fax:561-361-7457
Practice Address - Street 1:7700 CONGRESS AVENUE
Practice Address - Street 2:SUITE 1102
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487
Practice Address - Country:US
Practice Address - Phone:561-361-7484
Practice Address - Fax:561-361-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3240102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty