Provider Demographics
NPI:1366522930
Name:BURSTEIN, STUART SAMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:SAMUEL
Last Name:BURSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2033 WOOD ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-7900
Mailing Address - Country:US
Mailing Address - Phone:941-677-3366
Mailing Address - Fax:941-677-3367
Practice Address - Street 1:2033 WOOD ST
Practice Address - Street 2:SUITE 215
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-7900
Practice Address - Country:US
Practice Address - Phone:941-677-3366
Practice Address - Fax:941-677-3367
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-033681-E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01-1102319Medicaid
PAC34366Medicare UPIN
PA01-1102319Medicaid