Basic Information
Provider Information
NPI: 1063465276
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILSTEIN
FirstName: STEVEN
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 406 SW 12TH AVE
Address2:  
City: DEERFIELD BEACH
State: FL
PostalCode: 334423108
CountryCode: US
TelephoneNumber: 9544268840
FaxNumber: 9544266642
Practice Location
Address1: 2815 S SEACREST BLVD
Address2:  
City: BOYNTON BEACH
State: FL
PostalCode: 334357934
CountryCode: US
TelephoneNumber: 5617377733
FaxNumber: 5617377733
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 05/11/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XME0064346FLY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
26314660005FL MEDICAID


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