Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | ME77504 | FL |
NPI | 1386672426 |
---|---|
Provider Name | Gary I Kleiner |
First Address | Miami, FL 33136-1013 |
Second Address | Miami, FL 33136-1013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 11/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01141X | MEDICARE PTAN (01) | FL |
2617251-00 | (05) | FL |
G63266 | (02) | FL |