MEDICARE: SCOTT EVAN KLEIN DO

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	OS 6614	FL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	P00455173	OTHER	FL	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0803915	OTHER	FL	UHC EVERCARE & SEC HORIZ
2	139494	OTHER	FL	EYEMED
3	0805121	OTHER	FL	UNITED HEALTHCARE
4	80818	OTHER	FL	BLUE CROSS BLUE SHIELD
5	1682897	OTHER	FL	AETNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1003818261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT EVAN KLEIN DO

Provider Business Mailing Address
First Line	:	215 1ST ST N STE 200
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4507
Country	:	US
Telephone Number	:	863-294-5457
Fax Number	:	863-401-9398

Provider Business Practice Location Address
First Line	:	215 1ST ST N STE 200
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4507
Country	:	US
Telephone Number	:	863-294-5457
Fax Number	:	863-401-9398

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	12/01/2023

215 1ST ST N STE 200
WINTER HAVEN, FL
33881-4507

Practice Phone: 863-294-5457
Practice Fax: 836-293-0343