Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | ME119623 | FL |
N | 207QA0401X | Family Doctor - Addiction Medicine | ME119623 | FL |
N | 207RA0401X | Internist - Addiction Medicine | ME119623 | FL |
N | 207V00000X | Obstetrician & Gynecologist | 35040988 | OH |
NPI | 1184674848 |
---|---|
Provider Name | Stephen A. Straubing |
First Address | Gainesville, FL 32608-4006 |
Second Address | Gainesville, FL 32608-4006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 11/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0440982 | (05) | OH |
C01857 | (02) |