Provider Demographics
NPI:1003818261
Name:KLEIN, SCOTT EVAN (DO)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:EVAN
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:215 1ST ST N STE 200
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4507
Mailing Address - Country:US
Mailing Address - Phone:863-294-5457
Mailing Address - Fax:863-401-9398
Practice Address - Street 1:215 1ST ST N STE 200
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4507
Practice Address - Country:US
Practice Address - Phone:863-294-5457
Practice Address - Fax:863-401-9398
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 6614207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0803915OtherUHC EVERCARE & SEC HORIZ
FL139494OtherEYEMED
FL0805121OtherUNITED HEALTHCARE
FL80818OtherBLUE CROSS BLUE SHIELD
FL1682897OtherAETNA
FL254752000Medicaid
FLP00455173OtherRAILROAD MEDICARE
FL80818OtherBLUE CROSS BLUE SHIELD
FLF64843Medicare UPIN