Healthcare Provider Details

I. General information

NPI: 1679561237
Provider Name (Legal Business Name): STEVEN G TUCKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8444 SW 138TH ST
PALMETTO BAY FL
33158-1082
US

IV. Provider business mailing address

8444 SW 138TH ST
PALMETTO BAY FL
33158-1082
US

V. Phone/Fax

Practice location:
  • Phone: 305-779-5507
  • Fax:
Mailing address:
  • Phone: 305-799-5507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME46308
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: