Provider Demographics
NPI:1952909855
Name:KLUESNER, JOANNA MADONNA (OD)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:MADONNA
Last Name:KLUESNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:701 J C CENTER CT UNIT 18
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33954-2826
Mailing Address - Country:US
Mailing Address - Phone:941-624-3939
Mailing Address - Fax:941-624-3949
Practice Address - Street 1:701 J C CENTER CT UNIT 18
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954-2826
Practice Address - Country:US
Practice Address - Phone:941-624-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5874152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist