1972133635 NPI number — DR. BRITNI SKLENCAR DPM

Table of content: DR. BRITNI SKLENCAR DPM (NPI 1972133635)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972133635 NPI number — DR. BRITNI SKLENCAR DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SKLENCAR
Provider First Name:
BRITNI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972133635
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13801 BRUCE B DOWNS BLVD STE 205
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33613-3937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-971-4678
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17222 HOSPITAL BLVD STE 218
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKSVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34601-8925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-796-7800
Provider Business Practice Location Address Fax Number:
352-796-1203
Provider Enumeration Date:
01/22/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  PO4128 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: M2469 . This is a "MEDICARE GROUP PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 105456300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: M2501 . This is a "MEDICARE PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: M2475 . This is a "MEDICARE GROUP PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: M2500 . This is a "MEDICARE PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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