Provider Demographics
NPI:1063504371
Name:MACHLIN, STEVEN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ROBERT
Last Name:MACHLIN
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 1:6820 PORTO FINO CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-7133
Mailing Address - Country:US
Mailing Address - Phone:239-225-1364
Mailing Address - Fax:239-225-7337
Practice Address - Street 1:6820 PORTO FINO CIR STE 1
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-7133
Practice Address - Country:US
Practice Address - Phone:239-225-1364
Practice Address - Fax:239-225-7337
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME577032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00069814OtherMEDICARE RAILROAD
E16571Medicare UPIN
FL10483YMedicare ID - Type Unspecified