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General NPI Number Information
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NPI Number | 1720717226
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Entity Type | Individual
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Provider Name | MR. STEVEN JAMES REDDING
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Gender | Male
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 13471 FLADGATE MARK DR
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City | RIVERVIEW
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State | FL
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Zip | 33579-2379
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Country | US
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Telephone | 813-525-3140
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 512
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City | MANGO
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State | FL
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Zip | 33550-0512
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Country | US
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Telephone | 813-525-3140
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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 | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number | R352790814160
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License Number State | FL
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