Healthcare Provider Details

I. General information

NPI: 1487640975
Provider Name (Legal Business Name): STEPHEN MAIER KULVIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 11/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD EYE DEPT
MIAMI BEACH FL
33140-2800
US

IV. Provider business mailing address

4300 ALTON RD EYE DEPT
MIAMI BEACH FL
33140-2800
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2047
  • Fax: 305-674-2939
Mailing address:
  • Phone: 305-674-2047
  • Fax: 305-674-2939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number12339
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: