Provider Demographics
NPI:1902010697
Name:IRA M. STEIN, M.D., L.L.C
Entity Type:Organization
Organization Name:IRA M. STEIN, M.D., L.L.C
Other - Org Name:PEDIATRIC ENT OF THE PALM BEACHES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-204-4240
Mailing Address - Street 1:13005 SOUTHERN BLVD
Mailing Address - Street 2:BUILDING 1, SUITE 124
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9206
Mailing Address - Country:US
Mailing Address - Phone:561-204-4240
Mailing Address - Fax:561-204-4242
Practice Address - Street 1:13005 SOUTHERN BLVD
Practice Address - Street 2:BUILDING 1, SUITE 124
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9206
Practice Address - Country:US
Practice Address - Phone:561-204-4240
Practice Address - Fax:561-204-4242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0078470207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric OtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1285600791OtherNPI -INDIVIDUAL