Individual
P DEE G STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., P.A.
Contact information
Practice address
200 PALERMO PL, VENICE, FL 34285-2820
(941) 485-1121
(941) 486-0571
Mailing address
200 PALERMO PLACE, VENICE, FL 34285
(941) 485-1121
(941) 486-0571
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0051453
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058538001
DMERC
FL
05
—
063852800
—
FL
01
—
07275
BLUE CROSS BLUE SHIELD
FL
01
—
624839
AETNA
—
01
—
650058943
UNITED HEALTH CARE
—
01
—
FL0071799
TRICARE
FL
Enumeration date
03/30/2006
Last updated
03/24/2011
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