Healthcare Provider Details

I. General information

NPI: 1235244807
Provider Name (Legal Business Name): MARVIN L STEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 WILES RD STE 201
COCONUT CREEK FL
33073-3414
US

IV. Provider business mailing address

4515 WILES RD STE 201
COCONUT CREEK FL
33073-3414
US

V. Phone/Fax

Practice location:
  • Phone: 954-943-1133
  • Fax: 954-783-6845
Mailing address:
  • Phone: 954-943-1133
  • Fax: 954-783-6845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME 33072
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: