Healthcare Provider Details

I. General information

NPI: 1245295419
Provider Name (Legal Business Name): STEPHEN H LIVINGSTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 OKEECHOBEE BLVD FL 14
WEST PALM BEACH FL
33401-6349
US

IV. Provider business mailing address

525 OKEECHOBEE BLVD FL 14
WEST PALM BEACH FL
33401-6349
US

V. Phone/Fax

Practice location:
  • Phone: 561-804-0222
  • Fax:
Mailing address:
  • Phone: 561-804-0200
  • Fax: 561-804-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME56909
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME56909
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: