Healthcare Provider Details

I. General information

NPI: 1902802697
Provider Name (Legal Business Name): STEPHEN I. GATES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 WOODBRIAR TRL FL 32129
PORT ORANGE FL
32129-9626
US

IV. Provider business mailing address

36014 TH ST STOP 8143
LUBBOCK TX
79430-8143
US

V. Phone/Fax

Practice location:
  • Phone: 386-322-4701
  • Fax:
Mailing address:
  • Phone: 806-743-2757
  • Fax: 806-743-1071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License NumberME181421
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberF6654
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License NumberF6654
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: