MEDICARE: STEVEN TERSHESHEE PA-C

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	363A00000X	Physician Assistant	P9105306	FL

General Provider Information

NPI Number	:	1780604934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN TERSHESHEE PA-C

Provider Business Mailing Address
First Line	:	24 JADE DR APT 7
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-5622
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	491 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-5680
Country	:	US
Telephone Number	:	352-515-6000
Fax Number	:

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	08/16/2023

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