MEDICARE: KLEINS OF JACKSONVILLE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	P04081	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2127581	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558478750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KLEINS OF JACKSONVILLE INC

Provider Business Mailing Address
First Line	:	14330 JARRETTSVILLE PIKE
Second Line	:
City	:	PHOENIX
State	:	MD
Zip	:	21131-1743
Country	:	US
Telephone Number	:	410-666-1700
Fax Number	:	410-420-8228

Provider Business Practice Location Address
First Line	:	14330 JARRETTSVILLE PIKE
Second Line	:
City	:	PHOENIX
State	:	MD
Zip	:	21131-1743
Country	:	US
Telephone Number	:	410-666-1700
Fax Number	:	410-420-8228

Authorized Official
Title or Position	:	THIRD PARTY ADMINISTRATOR
Name	:	MELISSA FIGUEROA RIVERA
Credential	:
Telephone Number	:	732-521-8439

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	07/21/2011

Similar Medicare Providers

1861951345 — NICOLE NEUKUM
Practice Location Address:

14330 JARRETTSVILLE PIKE
PHOENIX, MD
21131-1743

Practice Phone: 410-666-1700
Practice Fax: 410-666-7140

1922561067 — HONG ROSADO
Practice Location Address:

14330 JARRETTSVILLE PIKE
PHOENIX, MD
21131-1743

Practice Phone: 410-666-1700
Practice Fax:

1215567011 — KLEINS OF JACKSONVILLE INC
Practice Location Address:

14330 JARRETTSVILLE PIKE
PHOENIX, MD
21131-1743

Practice Phone: 410-666-1700
Practice Fax:

1639012693 — ANNA LOUISE KOCK RN
Practice Location Address:

18079 N VILLA RITA DR
PHOENIX, AZ
85032-1743

Practice Phone: 602-809-0878
Practice Fax:

1184072894 — EUGENE L DE LA CRUZ DPM PC
Practice Location Address:

1743 W SIENNA BOUQUET PL
PHOENIX, AZ
85085-8040

Practice Phone: 631-827-8159
Practice Fax:

1972046571 — BISDAK ANKLE FOOT
Practice Location Address:

1743 W SIENNA BOUQUET PL
PHOENIX, AZ
85085-8040

Practice Phone: 631-827-8159
Practice Fax:

Directions to “KLEINS OF JACKSONVILLE INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.