Provider Demographics
NPI:1932184082
Name:KLEIN, LEE I (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:I
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:P.O. BOX 39209
Mailing Address - Street 2:
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33339
Mailing Address - Country:US
Mailing Address - Phone:954-851-9966
Mailing Address - Fax:954-318-7360
Practice Address - Street 1:1776 PINE ISLAND RD.
Practice Address - Street 2:SUITE 124
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322
Practice Address - Country:US
Practice Address - Phone:954-473-2608
Practice Address - Fax:954-473-4122
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42744207W00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD51043Medicare UPIN
FL04514ZMedicare PIN
FL04514Medicare PIN