Provider Demographics
NPI:1386773331
Name:PEARLSTEIN, STEVEN RUSSELL (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RUSSELL
Last Name:PEARLSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9110 NW 41ST MNR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-1758
Mailing Address - Country:US
Mailing Address - Phone:954-415-8693
Mailing Address - Fax:
Practice Address - Street 1:9110 NW 41ST MNR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1758
Practice Address - Country:US
Practice Address - Phone:954-415-8693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79374207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55340OtherBLUE CROSS- BLUE SHIELD
FLF41927Medicare UPIN
FL13401Medicare ID - Type Unspecified