Provider Demographics
NPI:1184672115
Name:STEINER, JERALD G (MD)
Entity Type:Individual
Prefix:
First Name:JERALD
Middle Name:G
Last Name:STEINER
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:PO BOX 15086
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-1086
Mailing Address - Country:US
Mailing Address - Phone:941-955-0360
Mailing Address - Fax:941-955-9806
Practice Address - Street 1:2750 BAHIA VISTA ST
Practice Address - Street 2:SUITE 250
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2600
Practice Address - Country:US
Practice Address - Phone:941-955-0360
Practice Address - Fax:941-955-9806
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME14166207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271229600Medicaid
FL58189ZMedicare ID - Type Unspecified
FL271229600Medicaid