Healthcare Provider Details

I. General information

NPI: 1750582979
Provider Name (Legal Business Name): STEPHANIE HALL D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CELEBRATION PL STE 200
CELEBRATION FL
34747-5432
US

IV. Provider business mailing address

410 CELEBRATION PL STE 200
CELEBRATION FL
34747-5432
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-5380
  • Fax:
Mailing address:
  • Phone: 407-303-4220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number4299
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number4299
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: