Provider Demographics
NPI:1346272275
Name:SZABO, STEPHEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:SZABO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 W WATERS AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2511
Mailing Address - Country:US
Mailing Address - Phone:813-932-9265
Mailing Address - Fax:813-935-4797
Practice Address - Street 1:2630 W WATERS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2511
Practice Address - Country:US
Practice Address - Phone:813-932-9265
Practice Address - Fax:813-935-4797
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00245882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052815300Medicaid
FLP00190357OtherRAILROAD MEDICARE PTAN
FL262907204Medicare PIN
FLD53693Medicare UPIN
FL29735ZMedicare ID - Type Unspecified