Provider Demographics
NPI:1154755700
Name:KLEIN, ANDREW L (CNIM)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:L
Last Name:KLEIN
Suffix:
Gender:M
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 HOLLY CT
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-7732
Mailing Address - Country:US
Mailing Address - Phone:850-322-6794
Mailing Address - Fax:
Practice Address - Street 1:617 HOLLY CT
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-7732
Practice Address - Country:US
Practice Address - Phone:850-322-6794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNIM-1598246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic