MEDICARE: ELIZABETH A KLEIN D.D.S.

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	122300000X	Dentist	DN19090	FL

General Provider Information

NPI Number	:	1336377258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH A KLEIN D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 1328
Second Line	:
City	:	HALLANDALE
State	:	FL
Zip	:	33008-1328
Country	:	US
Telephone Number	:	305-850-7272
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 E 25TH ST STE 218
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-3850
Country	:	US
Telephone Number	:	305-850-7272
Fax Number	:	305-390-1950

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

Provider Enumeration Date	:	06/30/2009
Last Update Date	:	08/18/2024

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