Healthcare Provider Details

I. General information

NPI: 1528846292
Provider Name (Legal Business Name): KATHRYN KELLEY STEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2023
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 S SEMORAN BLVD
ORLANDO FL
32807-3293
US

IV. Provider business mailing address

126 S SEMORAN BLVD
ORLANDO FL
32807-3293
US

V. Phone/Fax

Practice location:
  • Phone: 407-601-3292
  • Fax:
Mailing address:
  • Phone: 407-601-3292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS5645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: