Provider Demographics
NPI:1356881585
Name:STEELE, RAYMOND LACHLAN
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:LACHLAN
Last Name:STEELE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 863407
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3407
Mailing Address - Country:US
Mailing Address - Phone:941-408-7880
Mailing Address - Fax:941-408-7888
Practice Address - Street 1:842 SUNSET LAKE BLVD STE 401
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-7553
Practice Address - Country:US
Practice Address - Phone:941-408-7880
Practice Address - Fax:941-408-7888
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS16974207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine