Healthcare Provider Details

I. General information

NPI: 1912830258
Provider Name (Legal Business Name): STEPHEN ALEXANDER MCLEOD DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14633 COUNTY ROAD 565A
GROVELAND FL
34736-9748
US

IV. Provider business mailing address

9900 CANAL ZONE WAY
CLERMONT FL
34711-7835
US

V. Phone/Fax

Practice location:
  • Phone: 321-320-5840
  • Fax:
Mailing address:
  • Phone: 321-320-5840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN31733
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: