Healthcare Provider Details

I. General information

NPI: 1891137543
Provider Name (Legal Business Name): STEPHANIE ABELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 LORAINE DR APT 111
ALTAMONTE SPRINGS FL
32714-3314
US

IV. Provider business mailing address

230 LORAINE DR APT 111
ALTAMONTE SPRINGS FL
32714-3314
US

V. Phone/Fax

Practice location:
  • Phone: 386-801-6870
  • Fax:
Mailing address:
  • Phone: 386-801-6870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberTT15569
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: