Provider Demographics
NPI:1528068723
Name:KLAUS, ANITA J (MD)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:J
Last Name:KLAUS
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 1:1400 SW 80TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-7134
Mailing Address - Country:US
Mailing Address - Phone:315-447-8387
Mailing Address - Fax:352-304-5379
Practice Address - Street 1:1400 SW 80TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-7134
Practice Address - Country:US
Practice Address - Phone:315-447-8387
Practice Address - Fax:352-304-5379
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93120207RM1200X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007214300Medicaid
FLFY072YMedicare PIN
FL007214300Medicaid