Provider Demographics
NPI:1871551325
Name:STEVEN MACHLIN MD LLC
Entity type:Organization
Organization Name:STEVEN MACHLIN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MACHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-225-1364
Mailing Address - Street 1:6820 PORTO FINO CIRCLE
Mailing Address - Street 2:STE 1
Mailing Address - City:FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912
Mailing Address - Country:US
Mailing Address - Phone:239-225-1364
Mailing Address - Fax:239-225-7337
Practice Address - Street 1:6820 PORTO FINO CIRCLE
Practice Address - Street 2:STE 1
Practice Address - City:FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912
Practice Address - Country:US
Practice Address - Phone:239-225-1364
Practice Address - Fax:239-225-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDA7325OtherMEDICARE RAILROAD
K4953Medicare ID - Type UnspecifiedGROUP #