Provider Demographics
NPI:1275581589
Name:STEPHEN SCHREIBER, MD
Entity Type:Organization
Organization Name:STEPHEN SCHREIBER, MD
Other - Org Name:ORLANDO VASCULAR ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-629-0888
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0024551208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL055769200Medicaid
FL97238AMedicare PIN
FL97238Medicare PIN
FL055769200Medicaid
FLW12395Medicare UPIN