MEDICARE: MR. CHARLES MAURICE STEINMANN

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	225100000X	Physical Therapist	PT 11937	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	34-1853567-026	OTHER	FL	TRICARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	QV3	OTHER	FL	BLUE CROSS / BLUE SHIELD

General Provider Information

NPI Number	:	1518125392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES MAURICE STEINMANN

Provider Business Mailing Address
First Line	:	1912 STATE ROAD 44
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-8345
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1912 STATE ROAD 44
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-8345
Country	:	US
Telephone Number	:	386-423-1070
Fax Number	:	386-423-0780

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

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	05/28/2008

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