Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | ME37850 | FL |
NPI | 1528096500 |
---|---|
Provider Name | Dr. Robert C. Kline |
First Address | Clearwater, FL 33757-0660 |
Second Address | Clearwater, FL 33756-3846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
79598 | BCBS PROVIDER NUMBER (01) | FL |
D67315 | (02) | FL |