Provider Demographics
NPI:1376567172
Name:KLEIN, JAY (PA-C)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:KLEIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2685 SW 32ND PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7863
Mailing Address - Country:US
Mailing Address - Phone:352-732-9643
Mailing Address - Fax:352-732-2243
Practice Address - Street 1:2685 SW 32ND PL
Practice Address - Street 2:SUITE 100
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7863
Practice Address - Country:US
Practice Address - Phone:352-732-9643
Practice Address - Fax:352-732-2243
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA3717363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL073ZMedicare UPIN