MEDICARE: STUART B HIMMELSTEIN M.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	207R00000X	Internal Medicine Physician	ME 59597	FL

General Provider Information

NPI Number	:	1669441598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STUART B HIMMELSTEIN M.D.

Provider Business Mailing Address
First Line	:	5258 LINTON BLVD
Second Line	:	SUITE 206
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6540
Country	:	US
Telephone Number	:	561-495-9292
Fax Number	:	561-495-0221

Provider Business Practice Location Address
First Line	:	5258 LINTON BLVD
Second Line	:	SUITE 206
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6540
Country	:	US
Telephone Number	:	561-495-9292
Fax Number	:	561-495-0221

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	12/01/2008

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