Provider Demographics
NPI:1811266075
Name:KLEIN, KAYLA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9045 COLBY DR
Mailing Address - Street 2:#2423
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3333
Mailing Address - Country:US
Mailing Address - Phone:509-302-0272
Mailing Address - Fax:
Practice Address - Street 1:1606 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3798
Practice Address - Country:US
Practice Address - Phone:239-458-7427
Practice Address - Fax:239-458-7825
Is Sole Proprietor?:No
Enumeration Date:2011-12-17
Last Update Date:2011-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0046510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist