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NPI Code Detail

MEDICARE: DR. STEPHANIE LEE MATHEW MD

MEDICARE: DR. STEPHANIE LEE MATHEW 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
1390200000XStudent in an Organized Health Care Education/Training ProgramTX
2207Q00000XFamily Medicine PhysicianME179471FL
3207Q00000XFamily Medicine PhysicianU9310TX

General Provider Information

NPI Number : 1881221232
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE LEE MATHEW MD
Provider Business Mailing Address
First Line : 500 E CENTRAL AVE # 2
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33880-3053
Country : US
Telephone Number : 863-293-1191
Fax Number :
Provider Business Practice Location Address
First Line : 500 E CENTRAL AVE # 2
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33880-3053
Country : US
Telephone Number : 863-293-1191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2020
Last Update Date : 04/13/2026

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