Charles V. Klucka, D.O.

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

OS 0006759 Issued in FL

Practice address

9671 Gladiolus Dr
Suite #104
Fort Myers, FL 33908-7606

Phone

(239) 939-2246

Fax

(239) 267-2929

NPI assigned

Nov 7, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: charles.klucka@allergyklucka.directbygreenway.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1043490055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9671 GLADIOLUS DR",
            "address_2": "SUITE #104",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339087606",
            "telephone_number": "239-939-2246",
            "fax_number": "239-267-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9671 GLADIOLUS DR",
            "address_2": "SUITE #104",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339087606",
            "telephone_number": "239-939-2246",
            "fax_number": "239-267-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUCKA",
        "first_name": "CHARLES",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "FL",
            "license": "OS 0006759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul S Kling, PHD
• Stacy Kling
• Natalie Klingberg
• Joseph Clair Klink, M.D.
• Nikolaj Kljusev, MD
• John Peter Kmetz, P.A.
• Mila Kmezic, M.D.
• Knap Inc.
• Knap Inc.
• Michael Donald Knecht

• Allergy Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Allergy Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.