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General NPI Number Information
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NPI Number | 1073591533
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Entity Type | Individual
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Provider Name | STEPHEN ROSS DREZNIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 636 DEL PRADO BLVD S
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City | CAPE CORAL
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State | FL
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Zip | 33990-2668
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Country | US
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Telephone | 239-424-3123
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Fax | 239-424-4041
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-424-3123
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Fax | 239-424-4041
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 168449-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036132060
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME147800
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License Number State | FL
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