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Individual

MR. HARRISON BURT STEWARD IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2415 N ORANGE AVE STE 700, ORLANDO, FL 32804-5521
(407) 303-2474
(407) 303-0680
Mailing address
PO BOX 3749, ORLANDO, FL 32802-3749
(407) 228-7373
(407) 228-7393

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 2609
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
290052100
FL
Enumeration date
10/10/2006
Last updated
10/20/2020
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