MEDICARE: STEVEN KNEZEVICH, M.D., P.A.

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	207X00000X	Orthopaedic Surgery Physician	ME60554	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	:	1417251034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN KNEZEVICH, M.D., P.A.

Provider Business Mailing Address
First Line	:	3820 NORTHDALE BLVD.,
Second Line	:	SUITE 105A
City	:	TAMPA
State	:	FL
Zip	:	33624-1834
Country	:	US
Telephone Number	:	813-960-1655
Fax Number	:	813-960-3681

Provider Business Practice Location Address
First Line	:	3820 NORTHDALE BLVD.,
Second Line	:	SUITE 105A
City	:	TAMPA
State	:	FL
Zip	:	33624-1834
Country	:	US
Telephone Number	:	813-960-1655
Fax Number	:	813-960-3681

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	STEPHANIE PORTALES
Credential	:
Telephone Number	:	813-960-1655

Provider Enumeration Date	:	12/23/2010
Last Update Date	:	01/12/2012

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