MEDICARE: STEPHANIE RENEE DOVE FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	11030674	FL
2	363LF0000X	Family Nurse Practitioner	APRN11030674	FL

General Provider Information

NPI Number	:	1205490059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE RENEE DOVE FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 626
Second Line	:
City	:	LOUGHMAN
State	:	FL
Zip	:	33858-0626
Country	:	US
Telephone Number	:	720-737-1668
Fax Number	:

Provider Business Practice Location Address
First Line	:	2651 HAM BROWN RD
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-3415
Country	:	US
Telephone Number	:	407-452-1025
Fax Number	:	407-452-1068

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2019
Last Update Date	:	06/17/2025

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