Healthcare Provider Details
I. General information
NPI: 1396774956
Provider Name (Legal Business Name): STEFANO MION BET MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/03/2006
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13055 SW 42ND ST STE 108
MIAMI FL
33175
US
IV. Provider business mailing address
8660 W FLAGLER ST SUITE 200
MIAMI FL
33144-2031
US
V. Phone/Fax
- Phone: 305-204-9195
- Fax: 305-204-9196
- Phone: 305-227-3884
- Fax: 305-554-4833
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | ME75066 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 75066 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: