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General NPI Number Information
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NPI Number | 1811955362
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Entity Type | Individual
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Provider Name | STEPHEN PHILIP NIMBARGI MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 321 MAITLAND AVE STE 1000
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-5449
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Country | US
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Telephone | 407-331-6236
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Fax | 407-331-6953
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Provider Business Mailing Address
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Address Line | PO BOX 150038
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32715-0038
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Country | US
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Telephone | 407-782-3702
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Fax | 407-331-6953
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME85807
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME85807
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License Number State | FL
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