Provider Demographics
NPI:1235306150
Name:STEIN, COREY A (DC)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:A
Last Name:STEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 SW MARTIN HWY
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-3222
Mailing Address - Country:US
Mailing Address - Phone:772-324-9337
Mailing Address - Fax:772-324-9347
Practice Address - Street 1:2351 SW MARTIN HWY
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-3222
Practice Address - Country:US
Practice Address - Phone:772-324-9337
Practice Address - Fax:772-324-9347
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX7781-B111N00000X
FLCH14156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX7B001Medicare Oscar/Certification
NYU56165Medicare UPIN