Healthcare Provider Details

I. General information

NPI: 1538516299
Provider Name (Legal Business Name): MAGDALENA MARIA STEPIEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2016
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 E ROLLINS ST STE 6
ORLANDO FL
32804-5519
US

IV. Provider business mailing address

265 E ROLLINS ST STE 6
ORLANDO FL
32804-5519
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-6729
  • Fax:
Mailing address:
  • Phone: 407-303-6729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.068498
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number125068498
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME151364
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberME151364
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: