MEDICARE: WILLIAM H STEPHEN OD PA

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	152W00000X	Optometrist	OPC2897	FL

General Provider Information

NPI Number	:	1497931588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM H STEPHEN OD PA

Provider Business Mailing Address
First Line	:	5885 GUNN HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-4007
Country	:	US
Telephone Number	:	813-908-0100
Fax Number	:	813-908-0099

Provider Business Practice Location Address
First Line	:	5885 GUNN HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-4007
Country	:	US
Telephone Number	:	813-908-0100
Fax Number	:	813-908-0099

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILLIAM HENRY STEPHEN
Credential	:	O.D.
Telephone Number	:	813-908-0100

Provider Enumeration Date	:	01/18/2008
Last Update Date	:	07/26/2014

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