Provider Demographics
NPI:1043299456
Name:KESSLER, STEVEN GARY (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:GARY
Last Name:KESSLER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 E BROWARD BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2121
Mailing Address - Country:US
Mailing Address - Phone:954-496-4591
Mailing Address - Fax:
Practice Address - Street 1:1212 E BROWARD BLVD STE 204
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2121
Practice Address - Country:US
Practice Address - Phone:954-496-4591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA756142084P0800X, 2084P0805X
CT0315442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
J12482Medicare ID - Type Unspecified
F27475Medicare UPIN