Provider Demographics
NPI: | 1992876197 |
---|---|
Name: | KLIMAS, RIMA KRISTINA (OD) |
Entity type: | Individual |
Prefix: | |
First Name: | RIMA |
Middle Name: | KRISTINA |
Last Name: | KLIMAS |
Suffix: | |
Gender: | F |
Credentials: | OD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1911 N MILLS AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | ORLANDO |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32803-1407 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-893-8200 |
Mailing Address - Fax: | 407-893-8210 |
Practice Address - Street 1: | 260 LOOKOUT PL STE 105 |
Practice Address - Street 2: | |
Practice Address - City: | MAITLAND |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32751-4485 |
Practice Address - Country: | US |
Practice Address - Phone: | 407-647-7227 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-11-11 |
Last Update Date: | 2023-09-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | OPC3597 | 152W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | 7443808 | Other | AETNA |
FL | 621247600 | Medicaid | |
FL | 0160080 | Other | GHI |
FL | 5781943 | Other | CIGNA |
FL | 68256 | Other | BCBSFL |
FL | P00268792 | Medicare PIN | |
FL | 7443808 | Other | AETNA |
FL | 0160080 | Other | GHI |
FL | 68256 | Other | BCBSFL |