Basic Information
| Provider Information | |||||||||
| NPI: | 1861455503 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLEIN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10067 PINES BLVD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330246136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544307777 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10067 PINES BLVD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330246136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544307777 | ||||||||
| FaxNumber: | 9544303667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2006 | ||||||||
| LastUpdateDate: | 05/22/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | ME41602 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 00367 | 01 | FL | WELLCARE | OTHER | 00367 | 01 | FL | HEALTHEASE | OTHER | 067381100 | 05 | FL | MEDICAID | 4110330 | 01 | FL | AETNA | OTHER | 00367 | 01 | FL | STAYWELL | OTHER | 54315 | 01 | FL | SFCN | OTHER | 5461433 | 01 | FL | CIGNA | OTHER | D78855 | 01 | FL | VISTA | OTHER | 002125 | 01 | FL | NHP | OTHER |