MEDICARE: STEPHEN HOLCOMB II MS, CRNA

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	367500000X	Certified Registered Nurse Anesthetist	11001750	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

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	:	1912465105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN HOLCOMB II MS, CRNA

Provider Business Mailing Address
First Line	:	6095 17TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-5637
Country	:	US
Telephone Number	:	727-460-8014
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 PINELLAS ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3804
Country	:	US
Telephone Number	:	727-462-7000
Fax Number	:

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

Provider Enumeration Date	:	03/06/2019
Last Update Date	:	12/11/2025

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