Healthcare Provider Details

I. General information

NPI: 1265533228
Provider Name (Legal Business Name): LUISA SZTERN M.D. PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 10/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17200 NE 19TH AVE
NORTH MIAMI BEACH FL
33162-2210
US

IV. Provider business mailing address

17200 NE 19TH AVE
NORTH MIAMI BEACH FL
33162-2210
US

V. Phone/Fax

Practice location:
  • Phone: 305-944-2233
  • Fax: 305-944-2724
Mailing address:
  • Phone: 305-944-2233
  • Fax: 305-944-2724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberME 35002
License Number StateFL

VIII. Authorized Official

Name: DR. LUISA JUANA SZTERN
Title or Position: DIRECTOR
Credential: M.D.
Phone: 305-944-2233