Healthcare Provider Details

I. General information

NPI: 1316656036
Provider Name (Legal Business Name): BLAKE M STEIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 BISCAYNE BLVD APT 7122
MIAMI FL
33137-5304
US

IV. Provider business mailing address

2701 BISCAYNE BLVD APT 7122
MIAMI FL
33137-5304
US

V. Phone/Fax

Practice location:
  • Phone: 267-259-8227
  • Fax:
Mailing address:
  • Phone: 267-259-8227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number049656
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT42868
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: