Provider Demographics
NPI:1578160768
Name:SCHLONEGER, STEPHEN L (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:SCHLONEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:121 S ORANGE AVE
Mailing Address - Street 2:STE 940
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3234
Mailing Address - Country:US
Mailing Address - Phone:321-332-6947
Mailing Address - Fax:407-286-4515
Practice Address - Street 1:829 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2084
Practice Address - Country:US
Practice Address - Phone:407-332-0003
Practice Address - Fax:321-295-7928
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2021-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJNJDCATEMP-037353207Q00000X
PR000325-P.A208D00000X
FLTPPA72363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLTPPA72OtherPHYSICIAN ASSISTANT TELEHEALTH