Provider Demographics
NPI:1841354578
Name:FREDERICK J MCCLIMANS DO PA
Entity type:Organization
Organization Name:FREDERICK J MCCLIMANS DO PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCCLIMANS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:813-960-3228
Mailing Address - Street 1:11809 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3505
Mailing Address - Country:US
Mailing Address - Phone:813-960-3228
Mailing Address - Fax:813-960-0440
Practice Address - Street 1:11809 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-3505
Practice Address - Country:US
Practice Address - Phone:813-960-3228
Practice Address - Fax:813-960-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9141207X00000X
FLOS8857207X00000X
FLOS7010207X00000X
FLOS4739207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAK157Medicare PIN