Healthcare Provider Details

I. General information

NPI: 1174311104
Provider Name (Legal Business Name): JAMES EDWARD STIEREN OT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 8TH ST
CLERMONT FL
34711-2159
US

IV. Provider business mailing address

1240 WINTER GARDEN VINELAND RD APT Y7
WINTER GARDEN FL
34787-4340
US

V. Phone/Fax

Practice location:
  • Phone: 352-243-4422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT21311
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: