Healthcare Provider Details

I. General information

NPI: 1346243532
Provider Name (Legal Business Name): AARON BENNETT STEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1549 AIRPORT BLVD SUITE 440
PENSACOLA FL
32504-8633
US

IV. Provider business mailing address

P O BOX 2266
PENSACOLA FL
32513-2266
US

V. Phone/Fax

Practice location:
  • Phone: 850-475-2668
  • Fax: 850-475-2669
Mailing address:
  • Phone: 850-475-2668
  • Fax: 850-475-2669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME 61690
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: