Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PO 1505 | FL |
N | 222Z00000X | Podiatrist | PO 1505 | FL |
N | 213EP1101X | Primary Podiatric Medicine | PO 1505 | FL |
Y | 2081S0010X | Sports Medicine | PO 1505 | FL |
Y | 213ES0000X | Sports Medicine | PO 1505 | FL |
N | 213ES0131X | Foot Surgery | PO 1505 | FL |
NPI | 1043212566 |
---|---|
Provider Name | Dr. Marc B Klein |
First Address | Boca Raton, FL 33433-3426 |
Second Address | Boca Raton, FL 33433-3426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 05/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390121101 | (05) | FL |
480019906 | RAILROAD MEDICARE (01) | FL |
87854X | MEDICARE (01) | FL |
T51262 | (02) | FL |