MEDICARE: STEPHEN Z. GRAHOVAC MD

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	2085N0700X	Neuroradiology Physician	ME134268	FL
2	2085R0202X	Diagnostic Radiology Physician	ME134268	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275593311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN Z. GRAHOVAC MD

Provider Business Mailing Address
First Line	:	801 E DIXIE AVE STE 104
Second Line	:
City	:	LEESBURG
State	:	FL
Zip	:	34748-7601
Country	:	US
Telephone Number	:	352-365-2583
Fax Number	:	352-728-6749

Provider Business Practice Location Address
First Line	:	801 E DIXIE AVE STE 104
Second Line	:
City	:	LEESBURG
State	:	FL
Zip	:	34748-7601
Country	:	US
Telephone Number	:	352-787-5858
Fax Number	:	352-787-4655

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	07/28/2022

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