Healthcare Provider Details

I. General information

NPI: 1184293037
Provider Name (Legal Business Name): STEVEN DOUGLAS HALE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13101 S DIXIE HWY STE 400
PINECREST FL
33156-6530
US

IV. Provider business mailing address

13101 S DIXIE HWY STE 400
PINECREST FL
33156-6530
US

V. Phone/Fax

Practice location:
  • Phone: 786-467-5700
  • Fax:
Mailing address:
  • Phone: 786-467-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberME169342
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: