Provider Demographics
NPI:1124353313
Name:KLEIN, JOSEPH WESLEY (RPH)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WESLEY
Last Name:KLEIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 HARRELL AVE
Mailing Address - Street 2:
Mailing Address - City:TREASURE ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33706-3253
Mailing Address - Country:US
Mailing Address - Phone:727-512-5407
Mailing Address - Fax:
Practice Address - Street 1:9850 HARRELL AVE
Practice Address - Street 2:
Practice Address - City:TREASURE ISLAND
Practice Address - State:FL
Practice Address - Zip Code:33706-3253
Practice Address - Country:US
Practice Address - Phone:727-512-5407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9687183500000X
FLPS44741183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist