Van Kleeck, Phillip Edward

Van Kleeck, Phillip Edward is an individual health care provider with primary practice located at 2523 Us Highway 27 S Suite 130, Avon Park FL 33825-9690. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Van Kleeck, Phillip Edward can be contacted via phone (863) 991-5209.

Contact Information

Primary practice address
2523 Us Highway 27 S Suite 130 Avon Park FL 33825-9690
Phone: (863) 991-5209
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH 9545 Florida

Profile Details

NPI number 1093990061
LBN Legal business name Van Kleeck, Phillip Edward
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2008
Last updated Aug 18th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093990061 NPPES
Florida MEDICAID 1093990016

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