Healthcare Provider Details

I. General information

NPI: 1063412781
Provider Name (Legal Business Name): STEVEN MARK FLETCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 NE 30TH TER # 214
HOMESTEAD FL
33033-7613
US

IV. Provider business mailing address

925 NE 30TH TER # 214
HOMESTEAD FL
33033-7613
US

V. Phone/Fax

Practice location:
  • Phone: 305-245-5881
  • Fax: 786-533-1680
Mailing address:
  • Phone: 305-245-5881
  • Fax: 786-533-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME46707
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberME46707
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberME46707
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberME46707
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License NumberME46707
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: