Healthcare Provider Details

I. General information

NPI: 1942875935
Provider Name (Legal Business Name): LENAE STEVENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2021
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7550 43RD ST N
PINELLAS PARK FL
33781-3601
US

IV. Provider business mailing address

14100 58TH ST N STE 100
CLEARWATER FL
33760-9900
US

V. Phone/Fax

Practice location:
  • Phone: 727-824-8181
  • Fax:
Mailing address:
  • Phone: 727-824-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9121823
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: