Healthcare Provider Details

I. General information

NPI: 1588644710
Provider Name (Legal Business Name): STEPHEN CARLAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 02/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 W COPELAND DR
ORLANDO FL
32806-2028
US

IV. Provider business mailing address

89 W COPELAND DR
ORLANDO FL
32806-2028
US

V. Phone/Fax

Practice location:
  • Phone: 407-841-5281
  • Fax: 407-648-9879
Mailing address:
  • Phone: 407-841-5281
  • Fax: 407-648-9879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME55232
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberME55232
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: