Provider Demographics
NPI:1174520464
Name:BROWNSTEIN, SHELDON LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:LOUIS
Last Name:BROWNSTEIN
Suffix:
Gender:M
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:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-6410
Mailing Address - Fax:239-343-4014
Practice Address - Street 1:16261 BASS RD STE 300
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908
Practice Address - Country:US
Practice Address - Phone:239-343-6410
Practice Address - Fax:239-343-4014
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.061551207RC0001X
WI18214207RC0001X
IN01070859B207RC0001X
KY36510207RC0001X
FLME53359207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00893677OtherRAILROAD MEDICARE
KY0369208OtherMEDICARE
FL101195000Medicaid
OH0841254Medicaid
OH611300608069OtherCARESOURCE
KY0369015OtherMEDICARE
KY0969495OtherMEDICARE PTAN
IN200310750Medicaid
KY64025208Medicaid
KY0562615OtherMEDICARE
P00856621OtherRR MEDICARE
OH0860616Medicare PIN
KY0969495OtherMEDICARE PTAN
KY0369208OtherMEDICARE
P00856621OtherRR MEDICARE
OH0841254Medicaid
KY0369208OtherMEDICARE
OHP00893677OtherRAILROAD MEDICARE
OH611300608069OtherCARESOURCE