MEDICARE: STEPHEN M PIRRIS 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	207T00000X	Neurological Surgery Physician	ME103959	FL
2	207T00000X	Neurological Surgery Physician	22650	WI

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	:	1558568279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN M PIRRIS MD

Provider Business Mailing Address
First Line	:	4205 BELFORT RD STE 1100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-5876
Country	:	US
Telephone Number	:	904-296-3103
Fax Number	:	904-296-3106

Provider Business Practice Location Address
First Line	:	4205 BELFORT RD STE 1100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-5876
Country	:	US
Telephone Number	:	904-296-3103
Fax Number	:	904-296-3106

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

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	12/02/2022

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Directions to “ STEPHEN M PIRRIS MD” Practice Location

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