Provider Demographics
NPI:1205822004
Name:STERN, JOEL BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:BENJAMIN
Last Name:STERN
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 1:16445 COLLINS AVE
Mailing Address - Street 2:#2428
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4555
Mailing Address - Country:US
Mailing Address - Phone:305-773-2993
Mailing Address - Fax:
Practice Address - Street 1:16445 COLLINS AVE
Practice Address - Street 2:#2428
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160
Practice Address - Country:US
Practice Address - Phone:305-773-2993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN55745207P00000X
FLME76597207P00000X, 208M00000X
VA0101234295207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
F78654Medicare UPIN