Provider Demographics
NPI:1104048198
Name:KLEIN, GERALD JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:JOSEPH
Last Name:KLEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13389 VERDUN DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-1475
Mailing Address - Country:US
Mailing Address - Phone:561-630-5324
Mailing Address - Fax:
Practice Address - Street 1:189 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3100
Practice Address - Country:US
Practice Address - Phone:954-316-2442
Practice Address - Fax:954-316-2119
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 88698174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist