Provider Demographics
NPI:1811906886
Name:UNGER, STEPHEN WISE (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WISE
Last Name:UNGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4302 ALTON RD
Mailing Address - Street 2:SUITE 720
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2877
Mailing Address - Country:US
Mailing Address - Phone:305-532-4835
Mailing Address - Fax:305-532-0662
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 720
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2877
Practice Address - Country:US
Practice Address - Phone:305-532-4835
Practice Address - Fax:305-532-0662
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2021-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 0031943208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL066079500Medicaid
FL066079500Medicaid
FLD63646Medicare UPIN