Provider Demographics
NPI:1376909150
Name:STEPCHUK, BRIANNE
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:STEPCHUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ROYAL VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-2116
Mailing Address - Country:US
Mailing Address - Phone:610-761-5391
Mailing Address - Fax:
Practice Address - Street 1:4000 CENTRAL FLORIDA BLVD
Practice Address - Street 2:ATTN SPORTS MEDICINE- BRIANNE STEPCHUK
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-8005
Practice Address - Country:US
Practice Address - Phone:610-761-5391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 38862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer