Jack Marek Klem, MD PA

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

ME97440 Issued in FL

Legal business name

JACK MAREK KLEM, MD PA

Practice address

11760 SW 40TH St
Miami, FL 33175-3582

Phone

(305) 223-3000

NPI assigned

Jan 31, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jack Marek Klem, MDNPI 1871710004

Title

Owner

Phone

(786) 607-8047

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jack Marek Klem, M.D.

  • Neurological Surgery Physician
  • Colorado Springs, CO
  • NPI 1871710004

  FL

  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1174021414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13055 SW 42ND ST STE 201",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11760 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753582",
            "telephone_number": "305-223-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK MAREK KLEM, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "KLEM",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "MAREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-607-8047",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME97440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019067500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Karla Jacas
• Santiago J Jacinto, DDS
• Jack Bandel M.D., P.a.
• Jack Cohn D.D.S.,P.a.
• Jack D. Norman, M.D., P.a.
• Sarah Jacko
• Jackson Behavioral & Case Management Inc
• Jackson Behavioral & Case Management Services (Jackson Behavioral & Case Management Services Inc.)
• Sheila M Jackson Blazquez
• Jackson Clinic Center, Inc.

• Neurological Surgery Physician in Miami, FL
• Providers in Miami, FL by specialty
• Neurological Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.