Provider Demographics
NPI:1801573894
Name:KLAIBER, MARITZA NATASHA
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:NATASHA
Last Name:KLAIBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 BAYTHORN DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7801
Mailing Address - Country:US
Mailing Address - Phone:407-212-6474
Mailing Address - Fax:
Practice Address - Street 1:10920 MCKINLEY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-6471
Practice Address - Country:US
Practice Address - Phone:813-745-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027204363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner