Provider Demographics
NPI:1093880981
Name:TIECHE, STEVEN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CHARLES
Last Name:TIECHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:TIECHE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1920 SW 20TH PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7881
Mailing Address - Country:US
Mailing Address - Phone:352-237-1212
Mailing Address - Fax:352-237-0066
Practice Address - Street 1:1920 SW 20TH PL
Practice Address - Street 2:STE 201
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7881
Practice Address - Country:US
Practice Address - Phone:352-237-1212
Practice Address - Fax:352-237-0066
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 48914207L00000X
FLME48914208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3010XOtherMEDICARE
FL49587OtherBC PRVDR