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NPI Code Detail

MEDICARE: STEPHEN LEE BLYTHE D.O.

MEDICARE: STEPHEN LEE BLYTHE D.O.
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
1207Q00000XFamily Medicine PhysicianOS7433FL

General Provider Information

NPI Number : 1770685315
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN LEE BLYTHE D.O.
Provider Business Mailing Address
First Line : 1545 9TH ST SW
Second Line :
City : VERO BEACH
State : FL
Zip : 32962-4312
Country : US
Telephone Number : 772-257-8224
Fax Number : 772-213-3157
Provider Business Practice Location Address
First Line : 13505 US HIGHWAY 1
Second Line :
City : SEBASTIAN
State : FL
Zip : 32958-3759
Country : US
Telephone Number : 772-257-8224
Fax Number : 772-213-3157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2006
Last Update Date : 05/17/2023

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Directions to “ STEPHEN LEE BLYTHE D.O.” Practice Location

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