Provider Demographics
NPI:1285912733
Name:KLINE, NATASHA M (PA)
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:M
Last Name:KLINE
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Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 2066
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34460-2066
Mailing Address - Country:US
Mailing Address - Phone:352-563-0931
Mailing Address - Fax:352-563-0935
Practice Address - Street 1:3925 N LECANTO HWY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465-3507
Practice Address - Country:US
Practice Address - Phone:352-527-7336
Practice Address - Fax:352-513-2030
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2021-10-14
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110426400Medicaid