Provider Demographics
NPI:1215950589
Name:KLEBAN, DONNA H (MD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:H
Last Name:KLEBAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11551 SOUTHERN BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4254
Mailing Address - Country:US
Mailing Address - Phone:561-270-5505
Mailing Address - Fax:561-437-0177
Practice Address - Street 1:11551 SOUTHERN BLVD STE 2
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-4254
Practice Address - Country:US
Practice Address - Phone:561-270-5505
Practice Address - Fax:561-437-0177
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056902208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3245OtherWELLCARE
FL7583OtherDIMENSION
FLP301250OtherFREEDOM
FL051476400Medicaid
FL1007902OtherCAREPLUS
FLP971180OtherOPTIMUM
FL11776OtherBCBS
FL204143OtherAVMED
FL5134292OtherAETNA
FL204143OtherAVMED
FLP971180OtherOPTIMUM
FL7583OtherDIMENSION