MEDICARE: STEVEN BEHMKE

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	363L00000X	Nurse Practitioner	APRN11007898	FL

General Provider Information

NPI Number	:	1750908935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN BEHMKE

Provider Business Mailing Address
First Line	:	2924 NETWORK PL APT 103A
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33559-2132
Country	:	US
Telephone Number	:	407-712-5351
Fax Number	:

Provider Business Practice Location Address
First Line	:	2711 LETAP CT UNIT 101
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-7265
Country	:	US
Telephone Number	:	813-279-2211
Fax Number	:

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

Provider Enumeration Date	:	07/03/2020
Last Update Date	:	07/03/2020

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