Provider Demographics
NPI:1114029881
Name:ELLIOTT M STEIN MD PA
Entity Type:Organization
Organization Name:ELLIOTT M STEIN MD PA
Other - Org Name:THE CENTER FOR ADULT AND GERIATRIC PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-534-3636
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:SUITE 910
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2840
Mailing Address - Country:US
Mailing Address - Phone:305-534-3636
Mailing Address - Fax:
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE 910
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2840
Practice Address - Country:US
Practice Address - Phone:305-534-3636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00304362084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL059518700Medicaid