Provider Demographics
NPI:1346362506
Name:BRAUNSTEIN, STEWART (MD)
Entity Type:Individual
Prefix:
First Name:STEWART
Middle Name:
Last Name:BRAUNSTEIN
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 1:1257 TREEBAY LANE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34242
Mailing Address - Country:US
Mailing Address - Phone:941-349-0672
Mailing Address - Fax:
Practice Address - Street 1:1257 TREEBAY LANE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34242
Practice Address - Country:US
Practice Address - Phone:941-349-0672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME176112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D53796Medicare UPIN