Provider Demographics
NPI:1235857632
Name:STEIN, HEATHER ROSE (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ROSE
Last Name:STEIN
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 SW 116TH CT APT 107
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1708
Mailing Address - Country:US
Mailing Address - Phone:954-240-6792
Mailing Address - Fax:
Practice Address - Street 1:5915 PONCE DE LEON BLVD STE 23
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2435
Practice Address - Country:US
Practice Address - Phone:786-664-7810
Practice Address - Fax:305-340-2646
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11021562363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health