MEDICARE: DR. KIMBERLY RAE STEIN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS0005930	FL

General Provider Information

NPI Number	:	1073600656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY RAE STEIN DO

Provider Business Mailing Address
First Line	:	3100 17TH ST
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34769-6021
Country	:	US
Telephone Number	:	407-892-0009
Fax Number	:	407-892-3285

Provider Business Practice Location Address
First Line	:	3100 17TH ST
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34769-6021
Country	:	US
Telephone Number	:	407-892-0009
Fax Number	:	407-892-3285

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	03/07/2023

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