Provider Demographics
NPI:1073598785
Name:ADAIR, STEFAN RENE (MD)
Entity Type:Individual
Prefix:
First Name:STEFAN
Middle Name:RENE
Last Name:ADAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2677 S. TAMIAMI TRAIL
Mailing Address - Street 2:UNIT 3
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239
Mailing Address - Country:US
Mailing Address - Phone:941-955-5600
Mailing Address - Fax:941-870-8489
Practice Address - Street 1:2677 S. TAMIAMI TRAIL
Practice Address - Street 2:UNIT 3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-955-5600
Practice Address - Fax:941-870-8489
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87985208200000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA24BCBWDMedicare PIN
H51349Medicare UPIN
GA850776692BMedicaid