Provider Demographics
NPI:1619234812
Name:TREXLER, STEPHANIE THERESE (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:THERESE
Last Name:TREXLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 LAND O LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-2914
Mailing Address - Country:US
Mailing Address - Phone:813-428-7030
Mailing Address - Fax:813-769-2779
Practice Address - Street 1:1908 LAND O LAKES BLVD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-2914
Practice Address - Country:US
Practice Address - Phone:813-428-7030
Practice Address - Fax:813-769-2779
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME128331207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program