Provider Demographics
NPI:1861455503
Name:KLEIN, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10067 PINES BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6136
Mailing Address - Country:US
Mailing Address - Phone:954-430-7777
Mailing Address - Fax:
Practice Address - Street 1:10067 PINES BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6136
Practice Address - Country:US
Practice Address - Phone:954-430-7777
Practice Address - Fax:954-430-3667
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41602207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00367OtherWELLCARE
FL00367OtherHEALTHEASE
FL067381100Medicaid
FL4110330OtherAETNA
FL00367OtherSTAYWELL
FL54315OtherSFCN
FL5461433OtherCIGNA
FLD78855OtherVISTA
FL002125OtherNHP
FL002125OtherNHP
FL4110330OtherAETNA