Provider Demographics
NPI:1033491113
Name:BRONSTEIN, PETER ROBERT (ARNP, LMHC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:ROBERT
Last Name:BRONSTEIN
Suffix:
Gender:M
Credentials:ARNP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7859 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-3225
Mailing Address - Country:US
Mailing Address - Phone:561-809-8997
Mailing Address - Fax:
Practice Address - Street 1:7859 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-3225
Practice Address - Country:US
Practice Address - Phone:561-809-8997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3791101YM0800X
FL9233399363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health