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General NPI Number Information
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NPI Number | 1396438016
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Entity Type | Individual
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Provider Name | BRIA RAYE STEPHENS
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Gender | Female
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Dates
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Enumeration Date | 05/30/2023
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 755 N HWY 27/441
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City | LADY LAKE
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State | FL
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Zip | 32159
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Country | US
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Telephone | 352-751-6887
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Fax | 352-751-0302
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Provider Business Mailing Address
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Address Line | 33706 OVERTON DR
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City | LEESBURG
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State | FL
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Zip | 34788-3540
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Country | US
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Telephone | 352-871-4071
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Fax |
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | DO7230
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License Number State | FL
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