MEDICARE: STEPHEN SANDFORD ESTES 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	207V00000X	Obstetrics & Gynecology Physician	ME 93041	FL
2	207Q00000X	Family Medicine Physician	ME93041	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	:	1558399048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN SANDFORD ESTES MD

Provider Business Mailing Address
First Line	:	7215 CHATSWORTH CT
Second Line	:
City	:	UNIVERSITY PARK
State	:	FL
Zip	:	34201-2363
Country	:	US
Telephone Number	:	941-896-2150
Fax Number	:

Provider Business Practice Location Address
First Line	:	10910 E STATE ROAD 70
Second Line	:	SUITE 102 LWR FAMILY PRACTICE WALK-IN
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34202-8406
Country	:	US
Telephone Number	:	941-896-3900
Fax Number	:

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	04/27/2017

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