Provider Demographics
NPI:1740571132
Name:KLINGER, PAUL (RPH)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:KLINGER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3972 TOWN CENTER BLVD
Mailing Address - Street 2:PUBLIX PHARMACY
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837
Mailing Address - Country:US
Mailing Address - Phone:407-850-4361
Mailing Address - Fax:
Practice Address - Street 1:3972 TOWN CENTER BLVD
Practice Address - Street 2:PUBLIX PHARMACY
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6103
Practice Address - Country:US
Practice Address - Phone:407-850-4361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS22456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist