Healthcare Provider Details

I. General information

NPI: 1831107036
Provider Name (Legal Business Name): JOEL D STEIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 05/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4109 NORTH FEDERAL HIGHWAY
FORT LAUDERDALE FL
33308-5530
US

IV. Provider business mailing address

4109 NORTH FEDERAL HIGHWAY
FORT LAUDERDALE FL
33308-5530
US

V. Phone/Fax

Practice location:
  • Phone: 954-563-2707
  • Fax: 954-563-7009
Mailing address:
  • Phone: 954-563-2707
  • Fax: 954-563-7009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberOS4707
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: