Lauriel Bortnick Klinghoffer
Individual provider Active NPI Anesthesiologist Assistant · Mangonia Park, FL
NPI 1407102304 · NPPES record last updated Dec 21, 2022
Key facts
- NPI
- 1407102304
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiologist Assistant 367H00000X
- License
- AA186 (FL)
- Practice address
- 901 45TH St
Mangonia Park, FL 33407-2413 - Phone
- (561) 844-6300
- NPI assigned
- Jul 28, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- South Florida Anesthesia and Pain Treatment PA
Practice addresses (Care Compare)
901 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 844-6300
Hospital & facility affiliations
- St Mary'S Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121023000650 | GA | Practitioner - Anesthesiology Assistant | 9436309770 | Reassigns benefits to 1 organization |
| I20131011001268 | FL | Practitioner - Anesthesiology Assistant | 9436309770 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Associate of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cleveland Clinic Florida a Nonprofit Corporation | Current |
Accepting new patients | |
| Redmond Anesthesia and Pain Treatment, PC | Current |
Accepting new patients | |
| South Florida Anesthesia & Pain Treatment, P.a. | Current |
Accepting new patients |
Locations
901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300
2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000
501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | |||
| Anesthesiologist Assistant | 367H00000X | AA186 | FL | Yes |
Addresses
Primary practice location
901 45TH St
Mangonia Park, FL 33407-2413
Mailing address
2417 NW 49TH LN
Boca Raton, FL 33431-4337
Phone (561) 414-5338
Other providers in Mangonia Park, FL
- Gaetjens Tardellie Joseph
- Samantha Marie Kanuck
- Shannon Marie Keating
- Brittany Keatts
- Kidz Medical Services
- Karli Marie Kochman
- Shannon Koziel
- Sarah Lambert
- Lisa Leclair
- Angela Jayne Lindsay
All providers in Mangonia Park, FL · Anesthesiologist Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.