Healthcare Provider Details

I. General information

NPI: 1114029881
Provider Name (Legal Business Name): ELLIOTT M STEIN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 ALTON RD SUITE 910
MIAMI BEACH FL
33140-2840
US

IV. Provider business mailing address

4308 ALTON RD SUITE 910
MIAMI BEACH FL
33140-2840
US

V. Phone/Fax

Practice location:
  • Phone: 305-534-3636
  • Fax:
Mailing address:
  • Phone: 305-534-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME0030436
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberME0030436
License Number StateFL

VIII. Authorized Official

Name: DR. ELLIOTT MARTIN STEIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-534-3636