Healthcare Provider Details

I. General information

NPI: 1528031606
Provider Name (Legal Business Name): STEVEN EDWARD WEBER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 06/10/2020
Certification Date: 06/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W CRYSTAL LAKE ST SUITE 200
ORLANDO FL
32806-4475
US

IV. Provider business mailing address

25 W CRYSTAL LAKE ST SUITE 200
ORLANDO FL
32806-4475
US

V. Phone/Fax

Practice location:
  • Phone: 407-254-2500
  • Fax: 407-254-2557
Mailing address:
  • Phone: 407-254-2500
  • Fax: 407-254-2557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberOS8211
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: