Healthcare Provider Details

I. General information

NPI: 1508703794
Provider Name (Legal Business Name): MARY ELIZABETH CECELIA KLEIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 06/30/2026
Certification Date: 05/04/2026
Deactivation Date: 06/02/2026
Reactivation Date: 06/30/2026

III. Provider practice location address

3385 BURNS RD STE 106
PALM BEACH GARDENS FL
33410-4328
US

IV. Provider business mailing address

215 CHARTER WAY
WEST PALM BEACH FL
33407-6645
US

V. Phone/Fax

Practice location:
  • Phone: 561-691-0100
  • Fax:
Mailing address:
  • Phone: 239-675-8156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF01260605
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: