Healthcare Provider Details

I. General information

NPI: 1639253560
Provider Name (Legal Business Name): JEFFREY STUART EPSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6280 SUNSET DR SUITE 504
SOUTH MIAMI FL
33143-4827
US

IV. Provider business mailing address

6280 SUNSET DR SUITE 504
SOUTH MIAMI FL
33143-4827
US

V. Phone/Fax

Practice location:
  • Phone: 305-666-1774
  • Fax: 305-666-6708
Mailing address:
  • Phone: 305-666-1774
  • Fax: 305-666-6708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0059544
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: