Provider Demographics
NPI:1669643375
Name:BROWARD EYECARE ASSOCIATES
Entity Type:Organization
Organization Name:BROWARD EYECARE ASSOCIATES
Other - Org Name:DR KLEIN OPTOMETRY, PA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-564-2020
Mailing Address - Street 1:2502 E OAKLAND PARK BLVD
Mailing Address - Street 2:#2
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1601
Mailing Address - Country:US
Mailing Address - Phone:954-564-2020
Mailing Address - Fax:954-568-2020
Practice Address - Street 1:2502 E OAKLAND PARK BLVD
Practice Address - Street 2:#2
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1601
Practice Address - Country:US
Practice Address - Phone:954-564-2020
Practice Address - Fax:954-568-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1480152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT54775Medicare UPIN
FL0557270001Medicare NSC
FLEZ893AMedicare PIN