Provider Demographics
NPI:1184665606
Name:STEWART, STEPHANIE JULIET (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:JULIET
Last Name:STEWART
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 SWIFT RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5139
Mailing Address - Country:US
Mailing Address - Phone:941-921-3000
Mailing Address - Fax:941-921-3066
Practice Address - Street 1:4801 SWIFT RD
Practice Address - Street 2:SUITE F
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5139
Practice Address - Country:US
Practice Address - Phone:941-921-3000
Practice Address - Fax:941-921-3066
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-3139213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL50392OtherBCBS
FLV01572Medicare UPIN
FL50392XMedicare PIN