MEDICARE: STEPHANIE KLEIN RD, LDN

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	133V00000X	Registered Dietitian	ND7310	FL

General Provider Information

NPI Number	:	1275935736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE KLEIN RD, LDN

Provider Business Mailing Address
First Line	:	915 UPLAND ROAD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401
Country	:	US
Telephone Number	:	215-873-6459
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 UPLAND RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-7549
Country	:	US
Telephone Number	:	215-873-6459
Fax Number	:

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

Provider Enumeration Date	:	09/16/2014
Last Update Date	:	07/21/2022

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