Provider Demographics
NPI:1760667968
Name:CIMERBERG, STEVEN W (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:W
Last Name:CIMERBERG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:954-379-8994
Mailing Address - Fax:
Practice Address - Street 1:6037 KIMBERLY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-2811
Practice Address - Country:US
Practice Address - Phone:954-379-8994
Practice Address - Fax:954-977-2711
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5466207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5296298OtherAETNA PROVIDER NUMBER
FL80084OtherBLUECROSS BLUE SHEILD
FL80084Medicare PIN