Healthcare Provider Details

I. General information

NPI: 1275581589
Provider Name (Legal Business Name): STEPHEN SCHREIBER, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 12/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S ORLANDO AVE SUITE 105
WINTER PARK FL
32789-5543
US

IV. Provider business mailing address

1400 S ORLANDO AVE SUITE 105
WINTER PARK FL
32789-5543
US

V. Phone/Fax

Practice location:
  • Phone: 407-629-0888
  • Fax: 407-629-2580
Mailing address:
  • Phone: 407-629-0888
  • Fax: 407-629-2580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME0024551
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME0024551
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHEN SCHREIBER
Title or Position: PRESIDENT
Credential: MD
Phone: 407-629-0888