Provider Demographics
NPI:1962509877
Name:KLEIN, MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
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 1:3375 BURNS RD
Mailing Address - Street 2:STE 101
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4349
Mailing Address - Country:US
Mailing Address - Phone:561-622-6550
Mailing Address - Fax:561-622-6331
Practice Address - Street 1:3375 BURNS RD
Practice Address - Street 2:STE 101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4349
Practice Address - Country:US
Practice Address - Phone:561-622-6550
Practice Address - Fax:561-622-6331
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105265207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCV714XMedicare PIN
FLCV714YMedicare PIN
SCAA12805551Medicare PIN
SC150900Medicare UPIN