MEDICARE: JOEL D 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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	OS4707	FL

General Provider Information

NPI Number	:	1831107036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL D STEIN DO

Provider Business Mailing Address
First Line	:	4109 NORTH FEDERAL HIGHWAY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5530
Country	:	US
Telephone Number	:	954-563-2707
Fax Number	:	954-563-7009

Provider Business Practice Location Address
First Line	:	4109 NORTH FEDERAL HIGHWAY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5530
Country	:	US
Telephone Number	:	954-563-2707
Fax Number	:	954-563-7009

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	05/10/2011

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