=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174821490
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEVEN D. SHEINER OD, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/10/2011
-----------------------------------------------------
Last Update Date | 03/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7035 BERACASA WAY SUITE 101
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33433-3405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-391-3334
-----------------------------------------------------
Fax | 561-338-3432
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7035 BERACASA WAY SUITE 101
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33433-3405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-391-3334
-----------------------------------------------------
Fax | 561-338-3432
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. STEVEN D SHEINER
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 561-391-3334
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 3172
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------