Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35131065 | OH |
Y | 2080P0202X | Pediatric Cardiologist | ME153541 | FL |
NPI | 1114347523 |
---|---|
Provider Name | Jared David Klein |
First Address | Miramar, FL 33025-3925 |
Second Address | Hollywood, FL 33021-5423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2014 |
Last Update Date | 07/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
112641300 | (05) | FL |