Provider Demographics
NPI:1891793444
Name:KLEIN, NEIL STEWART (DPM)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:STEWART
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6212 SE FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-8108
Mailing Address - Country:US
Mailing Address - Phone:772-286-7115
Mailing Address - Fax:772-286-7778
Practice Address - Street 1:1701 SE HILLMOOR DR
Practice Address - Street 2:STE 14
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7552
Practice Address - Country:US
Practice Address - Phone:772-286-7115
Practice Address - Fax:772-286-7778
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1184213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T55510Medicare UPIN
FL87705Medicare ID - Type Unspecified