Individual
STEPHANIE COSTA BYRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8925 COLONIAL CENTER DR STE 1000, FORT MYERS, FL 33905-7813
(239) 343-9325
(239) 468-7950
Mailing address
PO BOX 2147, SUITE #450, FORT MYERS, FL 33902-2147
(239) 343-9325
(239) 468-7950
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
36849
AZ
208600000X
Surgery Physician
Primary
ME178827
FL
2086S0122X
Plastic and Reconstructive Surgery Physician
ME178827
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129958600
—
FL
Enumeration date
04/24/2007
Last updated
03/05/2026
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