Provider Demographics
NPI:1205004892
Name:STERN, LANA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:LANA
Middle Name:M
Last Name:STERN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1450 MADRUGA AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3148
Mailing Address - Country:US
Mailing Address - Phone:305-448-5006
Mailing Address - Fax:305-663-5809
Practice Address - Street 1:1450 MADRUGA AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3164
Practice Address - Country:US
Practice Address - Phone:305-448-5006
Practice Address - Fax:305-663-5809
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY3769103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75840Medicare PIN