Provider Demographics
NPI:1497719611
Name:BERNSTEIN, STUART J (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:J
Last Name:BERNSTEIN
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 1:21110 BISCAYNE BOULEVARD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1227
Mailing Address - Country:US
Mailing Address - Phone:305-937-4400
Mailing Address - Fax:305-931-5625
Practice Address - Street 1:21110 BISCAYNE BOULEVARD
Practice Address - Street 2:SUITE 405
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1227
Practice Address - Country:US
Practice Address - Phone:305-937-4400
Practice Address - Fax:305-931-5625
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0043863174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL96467YMedicare PIN
FLD63863Medicare UPIN