Healthcare Provider Details

I. General information

NPI: 1760667968
Provider Name (Legal Business Name): STEVEN W CIMERBERG D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6037 KIMBERLY BLVD
NORTH LAUDERDALE FL
33068-2811
US

IV. Provider business mailing address

1395 NW 167TH ST
MIAMI GARDENS FL
33169-5710
US

V. Phone/Fax

Practice location:
  • Phone: 954-379-8994
  • Fax: 954-977-2711
Mailing address:
  • Phone: 954-379-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS5466
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: