MEDICARE: DAVID M KLEIN, M.D., OPHTHALMOLOGIST, P.A.

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	207W00000X	Ophthalmology Physician	ME0034395	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710256110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID M KLEIN, M.D., OPHTHALMOLOGIST, P.A.

Provider Business Mailing Address
First Line	:	1600 TAMIAMI TRL
Second Line	:	SUITE 101
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-1017
Country	:	US
Telephone Number	:	941-764-0035
Fax Number	:	941-764-0037

Provider Business Practice Location Address
First Line	:	1600 TAMIAMI TRL
Second Line	:	SUITE 101
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-1017
Country	:	US
Telephone Number	:	941-764-0035
Fax Number	:	941-764-0037

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. DAVID MICHAEL KLEIN
Credential	:	M.D.
Telephone Number	:	941-764-0035

Provider Enumeration Date	:	12/14/2011
Last Update Date	:	12/14/2011

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