1942290499 NPI number — DR. MICHAEL W STEPPIE MD

Table of content: DR. MICHAEL W STEPPIE MD (NPI 1942290499)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942290499 NPI number — DR. MICHAEL W STEPPIE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEPPIE
Provider First Name:
MICHAEL
Provider Middle Name:
W
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942290499
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 690609
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32869-0609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-846-7546
Provider Business Mailing Address Fax Number:
321-206-5419

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
725 E OAK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KISSIMMEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34744-4591
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-846-7546
Provider Business Practice Location Address Fax Number:
321-206-5419
Provider Enumeration Date:
10/26/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207NS0135X , with the licence number:  ME88443 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 004666000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".