Healthcare Provider Details

I. General information

NPI: 1457792350
Provider Name (Legal Business Name): NATHAN KLEIN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4651 SHERIDAN ST STE 100
HOLLYWOOD FL
33021-3459
US

IV. Provider business mailing address

4651 SHERIDAN ST STE 100
HOLLYWOOD FL
33021-3459
US

V. Phone/Fax

Practice location:
  • Phone: 954-894-1500
  • Fax: 954-894-1526
Mailing address:
  • Phone: 954-894-1500
  • Fax: 954-894-1526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC5418
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: