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General NPI Number Information
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NPI Number | 1629048632
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Entity Type | Individual
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Provider Name | STEPHEN G FEDEC DO
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 400 COLONNADE DR STE 230
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City | PONTE VEDRA
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State | FL
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Zip | 32081-6237
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Country | US
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Telephone | 904-271-7540
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Fax | 904-376-3204
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Provider Business Mailing Address
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Address Line | PO BOX 746652
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City | ATLANTA
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State | GA
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Zip | 30374-6652
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Country | US
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Telephone | 904-202-2092
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Fax | 904-376-4075
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | OS9424
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | OS9424
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MB0593880
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 83246
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 30762
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License Number State | GA
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