MEDICARE: STEPHANIE RENEE RIED 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	208000000X	Pediatrics Physician	MD33627	DC
2	208000000X	Pediatrics Physician	MD047884L	PA
3	2081P0010X	Pediatric Rehabilitation Medicine Physician	ME111640	FL
4	208000000X	Pediatrics Physician	ME111640	FL

General Provider Information

NPI Number	:	1699749895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE RENEE RIED MD

Provider Business Mailing Address
First Line	:	PO BOX 191
Second Line	:
City	:	ROCKLAND
State	:	DE
Zip	:	19732-0191
Country	:	US
Telephone Number	:	302-651-6201
Fax Number	:	302-651-4945

Provider Business Practice Location Address
First Line	:	1717 S ORANGE AVE
Second Line	:	SUITE 100
City	:	ORLANDO
State	:	FL
Zip	:	32806-2944
Country	:	US
Telephone Number	:	407-650-7424
Fax Number	:	407-650-7020

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	03/14/2013

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Directions to “ STEPHANIE RENEE RIED MD” Practice Location

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