Provider Demographics
NPI:1144203928
Name:ORMAN, STEPHEN V (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:V
Last Name:ORMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4371 VERONICA S SHOEMAKER BLVD
Mailing Address - Street 2:ATTN: CREDENTIAL DEPARTMENT
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2216
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:836 SUNSET LAKE BLVD
Practice Address - Street 2:SUITE #101
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-7554
Practice Address - Country:US
Practice Address - Phone:941-408-0500
Practice Address - Fax:941-496-8558
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46777207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053123500Medicaid
58468XMedicare PIN
58468VMedicare PIN
FLD56982Medicare UPIN
FL053123500Medicaid