Provider Demographics
NPI:1063550994
Name:DR.STEVEN CIMERBERG
Entity type:Organization
Organization Name:DR.STEVEN CIMERBERG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CIMERBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-473-8787
Mailing Address - Street 1:10063 CLEARY BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1063
Mailing Address - Country:US
Mailing Address - Phone:954-473-8787
Mailing Address - Fax:
Practice Address - Street 1:10063 CLEARY BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1063
Practice Address - Country:US
Practice Address - Phone:954-473-8787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0S5466208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80084OtherBLUE CROSS BLUE SHEILD
FL80084Medicaid