Provider Demographics
NPI:1811298755
Name:LOBACZ-KLOOSTERMAN, ELZBIETA (PHD)
Entity type:Individual
Prefix:MRS
First Name:ELZBIETA
Middle Name:
Last Name:LOBACZ-KLOOSTERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 E LAS OLAS BLVD
Mailing Address - Street 2:108
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2334
Mailing Address - Country:US
Mailing Address - Phone:954-330-9737
Mailing Address - Fax:
Practice Address - Street 1:1314 E LAS OLAS BLVD
Practice Address - Street 2:108
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2334
Practice Address - Country:US
Practice Address - Phone:954-330-9737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist