Provider Demographics
NPI:1477559110
Name:REICHBACH, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:REICHBACH
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 1:2415 UNIVERSITY PKWY STE 215
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2809
Mailing Address - Country:US
Mailing Address - Phone:941-213-4444
Mailing Address - Fax:941-213-4440
Practice Address - Street 1:2415 UNIVERSITY PKWY STE 215
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243
Practice Address - Country:US
Practice Address - Phone:941-213-4444
Practice Address - Fax:941-213-4440
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM119100207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01553415Medicaid
NY01553415Medicaid
NYF80083Medicare UPIN