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General NPI Number Information
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NPI Number | 1700391414
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Entity Type | Organization
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Legal Business Name | MANASOTA OBGYN ASSOCIATES LLC
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 12/20/2017
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Provider Practice Location Address
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Address Line | 2401 UNIVERSITY PKWY STE 201
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City | SARASOTA
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State | FL
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Zip | 34243-2973
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Country | US
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Telephone | 941-359-8300
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Fax | 941-359-8310
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Provider Business Mailing Address
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Address Line | PO BOX 828
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City | TALLEVAST
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State | FL
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Zip | 34270-0828
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAWN STEPHENS
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Credential | MD
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Telephone | 941-359-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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