Healthcare Provider Details
I. General information
NPI: 1386672426
Provider Name (Legal Business Name): GARY I KLEINER M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/29/2006
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1580 NW 10TH AVE
MIAMI FL
33136-1013
US
IV. Provider business mailing address
1580 NW 10TH AVE
MIAMI FL
33136-1013
US
V. Phone/Fax
- Phone: 305-213-8533
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0201X |
| Taxonomy | Pediatric Allergy/Immunology Physician |
| License Number | ME77504 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | ME77504 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: