=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124045695
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL PAUL STEIN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2006
-----------------------------------------------------
Last Update Date | 01/24/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5602 MARQUESAS CIR STE 108
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-3343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-400-1211
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5602 MARQUESAS CIR STE 108
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-3343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-400-1211
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | ME63693
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------