MEDICARE: STEPHANIE SAAVEDRA

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	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	ISW15766	FL

General Provider Information

NPI Number	:	1740708569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SAAVEDRA

Provider Business Mailing Address
First Line	:	16630 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-1400
Country	:	US
Telephone Number	:	813-609-0464
Fax Number	:

Provider Business Practice Location Address
First Line	:	16630 N DALE MABRY HWY STE B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-1400
Country	:	US
Telephone Number	:	813-609-0464
Fax Number	:

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

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	06/03/2026

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