Healthcare Provider Details

I. General information

NPI: 1750200465
Provider Name (Legal Business Name): RISING TIDE FAMILY MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

12200 W COLONIAL DR STE 300G
WINTER GARDEN FL
34787-4133
US

IV. Provider business mailing address

12200 W COLONIAL DR STE 300G
WINTER GARDEN FL
34787-4133
US

V. Phone/Fax

Practice location:
  • Phone: 321-496-6881
  • Fax: 407-543-3485
Mailing address:
  • Phone: 321-496-6881
  • Fax: 407-543-3485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KRISTIN STEFFES
Title or Position: OWNER
Credential: MD
Phone: 321-496-6881