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NPI Code Detail

MEDICARE: SCOTT A STEVENS OD

MEDICARE: SCOTT A STEVENS OD
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
1152W00000XOptometristOPC 3403FL

General Provider Information

NPI Number : 1275644486
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT A STEVENS OD
Provider Business Mailing Address
First Line : 1360 E VENICE AVE
Second Line :
City : VENICE
State : FL
Zip : 34285-9066
Country : US
Telephone Number : 941-488-2020
Fax Number : 941-484-2200
Provider Business Practice Location Address
First Line : 1360 E VENICE AVE
Second Line :
City : VENICE
State : FL
Zip : 34285-9066
Country : US
Telephone Number : 941-488-2020
Fax Number : 941-484-2200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 06/04/2020

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Directions to “ SCOTT A STEVENS OD” Practice Location

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