Provider Demographics
NPI:1255600169
Name:HLADEK, STEPHEN G (AA)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:G
Last Name:HLADEK
Suffix:
Gender:M
Credentials:AA
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Mailing Address - Street 1:1613 HARRISON PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2896
Mailing Address - Country:US
Mailing Address - Phone:954-838-2588
Mailing Address - Fax:954-514-3979
Practice Address - Street 1:1300 MICCOSUKEE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5054
Practice Address - Country:US
Practice Address - Phone:954-838-2588
Practice Address - Fax:954-514-3979
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAA111367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant