Provider Demographics
NPI:1124069992
Name:KLOOSTERMAN, ESTEBAN MARTIN (MD)
Entity type:Individual
Prefix:
First Name:ESTEBAN
Middle Name:MARTIN
Last Name:KLOOSTERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3725
Mailing Address - Country:US
Mailing Address - Phone:954-491-2444
Mailing Address - Fax:954-491-8818
Practice Address - Street 1:1800 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3725
Practice Address - Country:US
Practice Address - Phone:954-491-2444
Practice Address - Fax:954-491-8818
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69589207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL46454OtherFL BC/BS
FL1036211OtherCARE PLUS
FL293291OtherAVMED
FL2593589OtherGHI
FL46454OtherFL BC/BS
FL46454XMedicare ID - Type Unspecified