1750587952 NPI number — STEPHANIE LYNN FINER BCABA, ITDS

Table of content: STEPHANIE LYNN FINER BCABA, ITDS (NPI 1750587952)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750587952 NPI number — STEPHANIE LYNN FINER BCABA, ITDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINER
Provider First Name:
STEPHANIE
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BCABA, ITDS
Provider Gender Code:
F

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:
1750587952
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8348 LITTLE RD STE 349
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW PORT RICHEY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34654-4919
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-741-3405
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4293 TATUM LOOP
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ODESSA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33556-2291
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-741-3405
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/25/2007

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: 106E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 222Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 019830600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 811800100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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