Individual
DR. STEPHEN W EUBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 DUNLAWTON AVE STE 2, PORT ORANGE, FL 32127-2916
(386) 322-8310
(386) 322-8370
Mailing address
151 SOUTHHALL LN STE 300, MAITLAND, FL 32751-7172
(407) 875-2080
(407) 650-3455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
23922
CO
207N00000X
Dermatology Physician
Primary
ME133377
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01239227
—
CO
01
—
070014537
RR MEDICARE
CO
01
—
30757
BCBS
CO
01
—
84-1511239
OTHER
CO
Enumeration date
09/02/2006
Last updated
03/17/2018
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