Provider Demographics
NPI:1821600222
Name:MILSTEIN, LYLE HOWARD
Entity Type:Individual
Prefix:MR
First Name:LYLE
Middle Name:HOWARD
Last Name:MILSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6260 HAWKES BLUFF AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3418
Mailing Address - Country:US
Mailing Address - Phone:954-609-7346
Mailing Address - Fax:
Practice Address - Street 1:6260 HAWKES BLUFF AVE
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331-3418
Practice Address - Country:US
Practice Address - Phone:954-609-7346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health