Basic Information
Provider Information
NPI: 1174527857
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEINBERG
FirstName: BRUCE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1325 SAN MARCO BLVD
Address2: SUITE 200
City: JACKSONVILLE
State: FL
PostalCode: 322078568
CountryCode: US
TelephoneNumber: 9043463465
FaxNumber: 9048586489
Practice Location
Address1: 1325 SAN MARCO BLVD STE 200
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322078566
CountryCode: US
TelephoneNumber: 9043463465
FaxNumber: 9043960388
Other Information
ProviderEnumerationDate: 06/09/2005
LastUpdateDate: 03/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XME64578FLN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XS0106XME64578FLN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
207XS0114XME64578FLN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
2086S0105XME64578FLY Allopathic & Osteopathic PhysiciansSurgerySurgery of the Hand

ID Information
IDTypeStateIssuerDescription
20001632401FLRAILROAD MEDICAREOTHER
3768601-0005FL MEDICAID


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