MEDICARE: DR. NEIL STEWART KLEIN D.P.M.

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	213E00000X	Podiatrist	PO1184	FL

General Provider Information

NPI Number	:	1891793444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL STEWART KLEIN D.P.M.

Provider Business Mailing Address
First Line	:	6212 SE FEDERAL HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-8108
Country	:	US
Telephone Number	:	772-286-7115
Fax Number	:	772-286-7778

Provider Business Practice Location Address
First Line	:	1701 SE HILLMOOR DR
Second Line	:	STE 14
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7552
Country	:	US
Telephone Number	:	772-286-7115
Fax Number	:	772-286-7778

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/08/2007

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