Gary L Stevensmdpa

NPI 1083825491 - Dermatology - 207ND0101X

NPI Details
NPI 1083825491
Enumeration Date 05/25/2007
Last Updated 04/11/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name GARY L GARY
Position PRESIDENT
Phone (863) 293-2147
Fax (863) 294-2767
Practice Location
475 E CENTRAL AVE
WINTER HAVEN FL, 33880-3051, US
Phone (863) 293-2147
Fax (863) 294-2767
Business Location
475 E CENTRAL AVE
WINTER HAVEN FL, 33880-3051, US
Phone (863) 293-2147
Fax (863) 294-2767
Toxanomy
Taxonomy Code 207ND0101X
License State Florida
License Number ME75661
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According to our database, Gary L Stevensmdpa NPI is 1083825491, taxonomy code is 207ND0101X and license number is ME75661, license state is located at Florida. Gary L Stevensmdpa physically located at 475 E Central Ave, Winter Haven FL, 33880-3051. NPI Number 1033115704 has the healthcare provider type.

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1083825491 NPI number is provided on an as is basis without warranty of any kind. 1083825491 is maintained by the National Plan & Provider Enumeration System. The contents of Gary L Stevensmdpa are for informational purposes only.