Provider Demographics
NPI:1386882165
Name:KLEINMAN, ROBERTA BETH
Entity type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:BETH
Last Name:KLEINMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ROBERTA
Other - Middle Name:BETH
Other - Last Name:NIEDERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:R,N/CDE
Mailing Address - Street 1:2501 NW 34TH PL
Mailing Address - Street 2:#35
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-5928
Mailing Address - Country:US
Mailing Address - Phone:954-975-3787
Mailing Address - Fax:954-975-3786
Practice Address - Street 1:2501 NW 34TH PL
Practice Address - Street 2:#35
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-5928
Practice Address - Country:US
Practice Address - Phone:954-975-3787
Practice Address - Fax:954-975-3786
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-01
Last Update Date:2009-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1794902163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse