Organization
P DEE G STEPHENSON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
P DEE G STEPHENSON M.D. (PRESIDENT)
(941) 485-1121
Entity
Organization
Contact information
Practice address
200 PALERMO PL, VENICE, FL 34285-2820
(941) 485-1121
(941) 486-0571
Mailing address
200 PALERMO PL, VENICE, FL 34285-2820
(941) 485-1121
(941) 486-0571
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063852800
—
FL
01
—
07275
BCBS
FL
Enumeration date
03/24/2011
Last updated
03/24/2011
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