Provider Demographics
NPI:1255499893
Name:KLEIN, SEYMOUR (DPM)
Entity Type:Individual
Prefix:DR
First Name:SEYMOUR
Middle Name:
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12180 28TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1820
Mailing Address - Country:US
Mailing Address - Phone:727-572-5449
Mailing Address - Fax:
Practice Address - Street 1:5017 SW 40TH PL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-9588
Practice Address - Country:US
Practice Address - Phone:954-575-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1412213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87751Medicare ID - Type UnspecifiedMEDICARE