Provider Demographics
NPI:1649575564
Name:KLASINSKI, JOSHUA STEPHEN (PA-C)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:STEPHEN
Last Name:KLASINSKI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:JOSUE
Other - Middle Name:ESTEBAN
Other - Last Name:KLASINSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:2814 14TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-5471
Mailing Address - Country:US
Mailing Address - Phone:813-349-7800
Mailing Address - Fax:813-349-7861
Practice Address - Street 1:2814 14TH AVE SE
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-5471
Practice Address - Country:US
Practice Address - Phone:813-349-7800
Practice Address - Fax:813-349-7861
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant