Provider Demographics
NPI:1558547604
Name:STEELE, JAMES K (PA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:K
Last Name:STEELE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1834
Mailing Address - Country:US
Mailing Address - Phone:407-897-3499
Mailing Address - Fax:407-896-9454
Practice Address - Street 1:1812 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1834
Practice Address - Country:US
Practice Address - Phone:407-897-3499
Practice Address - Fax:407-896-9454
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA1865363AM0700X, 363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3410258OtherCIGNA
FLP958520OtherOPTIMUM
FLP1019957OtherFREEDOM
FLY0J31OtherBCBS OF FL
FL5374908OtherAETNA
FL009563300Medicaid
FLP01213825OtherRAILROAD MCR
FLP1019957OtherFREEDOM
FL3410258OtherCIGNA