Healthcare Provider Details

I. General information

NPI: 1235662008
Provider Name (Legal Business Name): STEVEN QUACH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8330 LAKEWOOD RANCH BLVD
LAKEWOOD RANCH FL
34202-5174
US

IV. Provider business mailing address

11161 E SR 70 UNIT 110, PMB 166
LAKEWOOD RANCH FL
34202
US

V. Phone/Fax

Practice location:
  • Phone: 941-290-5400
  • Fax: 941-289-2492
Mailing address:
  • Phone: 941-290-5400
  • Fax: 941-289-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME159890
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: