Provider Demographics
NPI:1467526657
Name:JEFFREY L. STEIN, MD, PA
Entity Type:Organization
Organization Name:JEFFREY L. STEIN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-483-5500
Mailing Address - Street 1:9291 GLADES RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3959
Mailing Address - Country:US
Mailing Address - Phone:561-483-5500
Mailing Address - Fax:561-483-1478
Practice Address - Street 1:9291 GLADES RD
Practice Address - Street 2:SUITE 306
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3959
Practice Address - Country:US
Practice Address - Phone:561-483-5500
Practice Address - Fax:561-483-1478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57901207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1115Medicare PIN