Provider Demographics
NPI:1255856126
Name:KLEIN, KEVIN H (PHARMD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:H
Last Name:KLEIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5129 CYPRESS PALMS LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-5048
Mailing Address - Country:US
Mailing Address - Phone:813-465-0484
Mailing Address - Fax:
Practice Address - Street 1:5129 CYPRESS PALMS LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-5048
Practice Address - Country:US
Practice Address - Phone:813-465-0484
Practice Address - Fax:813-465-0484
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56102183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist