Provider Demographics
NPI:1003051939
Name:STEVEN RUSSELL PEARLSTEIN. MD, PA
Entity Type:Organization
Organization Name:STEVEN RUSSELL PEARLSTEIN. MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:PEARLSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-415-8693
Mailing Address - Street 1:4613 N UNIVERSITY DR # 471
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4602
Mailing Address - Country:US
Mailing Address - Phone:954-415-8693
Mailing Address - Fax:
Practice Address - Street 1:1250 E HALLANDALE BEACH BLVD PH 2
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4647
Practice Address - Country:US
Practice Address - Phone:954-456-0250
Practice Address - Fax:954-456-0820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79374207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty