MEDICARE: STEPHEN B. ROTHSTEIN,O.D.

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	152W00000X	Optometrist	OPC001180	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	19375	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1427449594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN B. ROTHSTEIN,O.D.

Provider Business Mailing Address
First Line	:	7900 W MCNAB RD
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4303
Country	:	US
Telephone Number	:	954-722-9151
Fax Number	:	954-597-7222

Provider Business Practice Location Address
First Line	:	7900 W MCNAB RD
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4303
Country	:	US
Telephone Number	:	954-722-9151
Fax Number	:	954-597-7222

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. STEPHEN B ROTHSTEIN
Credential	:	O.D.
Telephone Number	:	954-722-9151

Provider Enumeration Date	:	02/11/2015
Last Update Date	:	08/24/2015

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