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NPI Code Detail

MEDICARE: MS. STEPHANIE CARMEN OBERWEGER PA-C

MEDICARE: MS. STEPHANIE CARMEN OBERWEGER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician AssistantPA9110779FL
2363AM0700XMedical Physician AssistantPA9110779FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164934006
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEPHANIE CARMEN OBERWEGER PA-C
Provider Business Mailing Address
First Line : 8124 CHIANTI DR
Second Line :
City : ORLANDO
State : FL
Zip : 32836-5311
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8124 CHIANTI DR
Second Line :
City : ORLANDO
State : FL
Zip : 32836-5311
Country : US
Telephone Number : 407-797-3630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2017
Last Update Date : 11/01/2017

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