Individual
STEPHEN CHARLES ROMAGNOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6824 SUWANNEE PLAZA LN, PMB 173, LIVE OAK, FL 32060-7495
(813) 416-7888
Mailing address
6824 SUWANNEE PLAZA LN, PMB 173, LIVE OAK, FL 32060-7495
(813) 416-7888
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME91099
FL
207ND0101X
MOHS-Micrographic Surgery Physician
ME91099
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271046300
—
FL
Enumeration date
09/12/2006
Last updated
09/05/2008
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