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General NPI Number Information
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NPI Number | 1932402955
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Entity Type | Organization
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Legal Business Name | LARRY E. STEVENS, M.D.
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Dates
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Enumeration Date | 12/14/2010
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Last Update Date | 12/14/2010
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Provider Practice Location Address
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Address Line | 120 STATE ST E STE 106
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City | OLDSMAR
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State | FL
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Zip | 34677-3647
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Country | US
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Telephone | 813-855-2969
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Fax | 813-891-6931
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Provider Business Mailing Address
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Address Line | 120 STATE ST E STE 106
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City | OLDSMAR
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State | FL
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Zip | 34677-3647
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Country | US
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Telephone | 813-855-2969
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Fax | 813-891-6931
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Authorized Official
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Title or Position | BILLING OWNER
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Name | MS. CHERYL LYNN E SWEENEY
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Credential |
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Telephone | 727-289-6326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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