Provider Demographics
NPI:1205827417
Name:SCHREIBER, STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:SCHREIBER
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 1:1400 S ORLANDO AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5543
Mailing Address - Country:US
Mailing Address - Phone:407-629-0888
Mailing Address - Fax:407-629-2580
Practice Address - Street 1:1400 S ORLANDO AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5543
Practice Address - Country:US
Practice Address - Phone:407-629-0888
Practice Address - Fax:407-629-2580
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0024551208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL038485200Medicaid
FL3700010OtherUNITED HEALTH CARE
FL6096760001Medicare NSC
FLD67183Medicare PIN
FL3700010OtherUNITED HEALTH CARE
FL038485200Medicaid