Provider Demographics
NPI:1053500264
Name:STEVEN PRICE MD PA
Entity Type:Organization
Organization Name:STEVEN PRICE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-325-4888
Mailing Address - Street 1:9060 SW 73RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2961
Mailing Address - Country:US
Mailing Address - Phone:305-325-4888
Mailing Address - Fax:305-547-1508
Practice Address - Street 1:9060 SW 73RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2961
Practice Address - Country:US
Practice Address - Phone:305-325-4888
Practice Address - Fax:305-547-1508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058734600Medicaid
FL1053500264OtherGROUP NPI
FL1083768055OtherNPI
FL037155600OtherMEDICAID INDIVIDUAL IDENTIFIER NUMBER
FL058734600Medicaid