Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | ME78470 | FL |
NPI | 1285600791 |
---|---|
Provider Name | Dr. Ira Michael Stein |
First Address | Loxahatchee, FL 33470-9206 |
Second Address | Loxahatchee, FL 33470-9206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 09/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
256820900 | (05) | FL |