Provider Demographics
NPI:1871597732
Name:STEINHART, CORKLIN RAY (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:CORKLIN
Middle Name:RAY
Last Name:STEINHART
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 FRUITVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-1926
Mailing Address - Country:US
Mailing Address - Phone:941-366-0134
Mailing Address - Fax:239-591-6726
Practice Address - Street 1:1825 HURLBURT RD STE 14
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-3737
Practice Address - Country:US
Practice Address - Phone:215-756-1220
Practice Address - Fax:239-591-6726
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51905207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL039625700Medicaid
FL039625700Medicaid
FLE75795Medicare UPIN