Healthcare Provider Details
I. General information
NPI: 1902651094
Provider Name (Legal Business Name): MALIA CLAIRE STEELE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/22/2024
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
620 JOHN PAUL JONES CIR
PORTSMOUTH VA
23708-2111
US
IV. Provider business mailing address
160 WILLADEL DR
BELLEAIR FL
33756-1942
US
V. Phone/Fax
- Phone: 727-482-0300
- Fax:
- Phone: 727-482-0300
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171000000X |
| Taxonomy | Military Health Care Provider |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: