Provider Demographics
NPI:1346795812
Name:STEFANO MION BET MD PA
Entity Type:Organization
Organization Name:STEFANO MION BET MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFANO
Authorized Official - Middle Name:
Authorized Official - Last Name:MION BET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-204-9195
Mailing Address - Street 1:13055 SW 42ND ST STE 108
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3409
Mailing Address - Country:US
Mailing Address - Phone:305-204-9195
Mailing Address - Fax:305-204-9196
Practice Address - Street 1:13055 SW 42ND ST STE 108
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-204-9195
Practice Address - Fax:305-204-9196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75066207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259691100Medicaid