Provider Demographics
NPI:1881134344
Name:BELL, STEPHANIE K (PA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:K
Last Name:BELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3301 N CAROLWOOD PT
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34442-8924
Mailing Address - Country:US
Mailing Address - Phone:352-897-0063
Mailing Address - Fax:866-502-8021
Practice Address - Street 1:8618 SW 103RD STREET RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-7705
Practice Address - Country:US
Practice Address - Phone:352-897-0063
Practice Address - Fax:866-502-8021
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9110032363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020287100Medicaid
FLIX471ZMedicare PIN