Provider Demographics
NPI:1801190871
Name:FLAX, STEVEN TODD (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:TODD
Last Name:FLAX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:915 SYMPHONY BEACH LN
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2738
Mailing Address - Country:US
Mailing Address - Phone:863-838-2888
Mailing Address - Fax:813-649-9777
Practice Address - Street 1:235 APOLLO BEACH BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2251
Practice Address - Country:US
Practice Address - Phone:863-838-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLL668207L00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD-56654Medicare UPIN