Provider Demographics
NPI:1265471502
Name:STYNE, PHILIP N (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:N
Last Name:STYNE
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 1:2501 NORTH ORANGE AVE.
Mailing Address - Street 2:SUITE 235
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804
Mailing Address - Country:US
Mailing Address - Phone:407-303-3096
Mailing Address - Fax:407-303-2553
Practice Address - Street 1:2501 NORTH ORANGE AVE.
Practice Address - Street 2:SUITE 235
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804
Practice Address - Country:US
Practice Address - Phone:407-303-3096
Practice Address - Fax:407-303-2553
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME33416207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043958400Medicaid
FL476262Medicare ID - Type Unspecified
FL043958400Medicaid