Provider Demographics
NPI:1952391518
Name:STEIN, BERNARDO (MD)
Entity Type:Individual
Prefix:
First Name:BERNARDO
Middle Name:
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BERNARDO
Other - Middle Name:
Other - Last Name:STEIN ROSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:455 PINELLAS ST
Mailing Address - Street 2:STE 400
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3354
Mailing Address - Country:US
Mailing Address - Phone:727-445-1992
Mailing Address - Fax:727-445-1993
Practice Address - Street 1:455 PINELLAS ST
Practice Address - Street 2:STE 400
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3354
Practice Address - Country:US
Practice Address - Phone:727-445-1911
Practice Address - Fax:727-445-1986
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64360207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373955400Medicaid
23099ZMedicare ID - Type Unspecified
F68072Medicare UPIN