Provider Demographics
NPI:1154373322
Name:KLAUS, NELSON C III (MD)
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:C
Last Name:KLAUS
Suffix:III
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 1:2090 SE OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3304
Mailing Address - Country:US
Mailing Address - Phone:772-287-8777
Mailing Address - Fax:772-287-1996
Practice Address - Street 1:2090 SE OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3304
Practice Address - Country:US
Practice Address - Phone:772-287-8777
Practice Address - Fax:772-287-1996
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82002174400000X
FLME-82002207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261090600Medicaid
H36297Medicare UPIN
FL261090600Medicaid