Individual
BRIAN STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1201 1ST ST S STE 100A, WINTER HAVEN, FL 33880-3904
(863) 280-6082
Mailing address
1201 1ST ST S STE 100A, WINTER HAVEN, FL 33880-3904
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
59-2796965
FL
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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