Basic Information
Provider Information
NPI: 1841266905
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FELDMAN
FirstName: STEVEN
MiddleName: LEE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7351 W OAKLAND PARK BLVD
Address2: STE 104
City: TAMARAC
State: FL
PostalCode: 333197107
CountryCode: US
TelephoneNumber: 9547415800
FaxNumber: 9547417828
Practice Location
Address1: 7351 W OAKLAND PARK BLVD
Address2: STE 104
City: TAMARAC
State: FL
PostalCode: 333197107
CountryCode: US
TelephoneNumber: 9547415800
FaxNumber: 9547417828
Other Information
ProviderEnumerationDate: 02/27/2006
LastUpdateDate: 09/01/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500XME0035390FLY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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