=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235662008
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN QUACH MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2017
-----------------------------------------------------
Last Update Date | 12/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8330 LAKEWOOD RANCH BLVD
-----------------------------------------------------
City | LAKEWOOD RANCH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34202-5174
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-290-5400
-----------------------------------------------------
Fax | 941-289-2492
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11161 E SR 70 UNIT 110, PMB 166
-----------------------------------------------------
City | LAKEWOOD RANCH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-290-5400
-----------------------------------------------------
Fax | 941-289-2492
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | ME159890
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------