Provider Demographics
NPI:1508816885
Name:KLIMBERG, IRA W (MD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:W
Last Name:KLIMBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 SW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7439
Mailing Address - Country:US
Mailing Address - Phone:325-237-6162
Mailing Address - Fax:352-237-7286
Practice Address - Street 1:3201 SW 34TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7439
Practice Address - Country:US
Practice Address - Phone:325-237-6162
Practice Address - Fax:352-237-7286
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39334208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL68154700Medicaid
FL68154700Medicaid
FL79731YMedicare ID - Type Unspecified