Provider Demographics
NPI:1720191786
Name:STERN, RONALD J (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:J
Last Name:STERN
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 1:989 SEBASTIAN BLVD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-4879
Mailing Address - Country:US
Mailing Address - Phone:727-617-1777
Mailing Address - Fax:888-836-2202
Practice Address - Street 1:989 SEBASTIAN BLVD UNIT 3
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-4879
Practice Address - Country:US
Practice Address - Phone:727-617-1777
Practice Address - Fax:888-836-2203
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39647207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7677351OtherCIGNA
FL003089200Medicaid
FL04689OtherBCBSFL
FL116589900Medicaid
FL4038984OtherAETNA
FLOL553OtherFL HF
FLP00705573OtherRR MEDICARE