Healthcare Provider Details

I. General information

NPI: 1093880981
Provider Name (Legal Business Name): STEVEN CHARLES TIECHE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: STEVE TIECHE M.D.

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 01/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 SW 20TH PL STE 201
OCALA FL
34471-7881
US

IV. Provider business mailing address

1920 SW 20TH PL
OCALA FL
34471-7881
US

V. Phone/Fax

Practice location:
  • Phone: 352-237-1212
  • Fax: 352-237-0066
Mailing address:
  • Phone: 352-237-1212
  • Fax: 352-237-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME 48914
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME48914
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: