Provider Demographics
NPI:1902894264
Name:STEINBERG, FRED ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:ALAN
Last Name:STEINBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13710 SW 84TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4040
Mailing Address - Country:US
Mailing Address - Phone:305-387-3896
Mailing Address - Fax:305-387-7384
Practice Address - Street 1:13710 SW 84TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4040
Practice Address - Country:US
Practice Address - Phone:305-387-3896
Practice Address - Fax:305-387-7384
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3024111N00000X
CO4026111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
88340OtherBLUE CROSS BLUE SHIELD
T55791Medicare UPIN
88340Medicare ID - Type Unspecified