MEDICARE: STEFAN SAMUEL MANN MD

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
1	207Q00000X	Family Medicine Physician	ME145111	FL
2	208D00000X	General Practice Physician	ME145111	FL
3	208M00000X	Hospitalist Physician	ME145111	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1356847388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFAN SAMUEL MANN MD

Provider Business Mailing Address
First Line	:	817 NW 56TH TER STE B
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32605-6401
Country	:	US
Telephone Number	:	352-234-3050
Fax Number	:	352-553-4800

Provider Business Practice Location Address
First Line	:	817 NW 56TH TER STE B
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32605-6401
Country	:	US
Telephone Number	:	352-234-3050
Fax Number	:	352-553-4800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2018
Last Update Date	:	11/25/2025

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