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General NPI Number Information
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NPI Number | 1700804168
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Entity Type | Individual
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Provider Name | STEPHEN R. VIJAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 200 SE HOSPITAL AVE
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City | STUART
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State | FL
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Zip | 34994-2346
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Country | US
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Telephone | 772-287-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 14828 ROLLING ROCK PL
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City | WELLINGTON
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State | FL
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Zip | 33414-7687
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Country | US
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Telephone | 614-580-0608
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME166208
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License Number State | FL
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