Provider Demographics
NPI:1033301155
Name:STEPHEN J SZABO MD PA
Entity Type:Organization
Organization Name:STEPHEN J SZABO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SZABO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-932-9265
Mailing Address - Street 1:2630 W WATERS AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2511
Mailing Address - Country:US
Mailing Address - Phone:813-932-9265
Mailing Address - Fax:813-935-4797
Practice Address - Street 1:2630 W WATERS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2511
Practice Address - Country:US
Practice Address - Phone:813-932-9265
Practice Address - Fax:813-935-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057624700Medicaid
FL00143Medicare PIN