Individual
DR. STEPHEN E MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 N CLYDE MORRIS BLVD, SUITE 1, DAYTONA BEACH, FL 32114-2733
(386) 238-3289
(386) 238-3296
Mailing address
PO BOX 9671, DAYTONA BEACH, FL 32120-9671
(386) 676-7130
(386) 676-7125
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
239076
NY
207R00000X
Internal Medicine Physician
ME103969
FL
207RC0000X
Cardiovascular Disease Physician
ME103969
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME103969
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001218000
—
FL
01
—
145H9
BCBS
FL
01
—
1851309629
TRICARE
FL
01
—
P00913614
RAILROAD MEDICARE
FL
Enumeration date
08/04/2006
Last updated
07/17/2013
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