Provider Demographics
NPI:1053485318
Name:STEIN, JEFFREY LEE (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LEE
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9291 GLADES RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3959
Mailing Address - Country:US
Mailing Address - Phone:561-483-5500
Mailing Address - Fax:561-483-1478
Practice Address - Street 1:9291 GLADES RD
Practice Address - Street 2:SUITE 306
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3959
Practice Address - Country:US
Practice Address - Phone:561-483-5500
Practice Address - Fax:561-483-1478
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57901207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF06796Medicare UPIN
FL14272AMedicare PIN