Individual
STEPHEN LANDREVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3066 SW MARTIN DOWNS BLVD, PALM CITY, FL 34990-2683
(954) 994-9908
Mailing address
7233 NW 116TH WAY, PARKLAND, FL 33076-3356
(954) 994-9908
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
21687
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21687
STATE LICENSE
FL
Enumeration date
11/09/2020
Last updated
11/09/2020
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