Healthcare Provider Details

I. General information

NPI: 1417199902
Provider Name (Legal Business Name): STEPHEN CHARLES VIEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 W INDIAN RIVER BLVD STE 2
EDGEWATER FL
32132-3500
US

IV. Provider business mailing address

602 W INDIAN RIVER BLVD STE 2
EDGEWATER FL
32132-3500
US

V. Phone/Fax

Practice location:
  • Phone: 386-868-2619
  • Fax: 386-868-5498
Mailing address:
  • Phone: 386-868-2619
  • Fax: 386-868-5498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberME115213
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME115213
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: