Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME46707 | FL |
N | 207YP0228X | Pediatric Otolaryngology | ME46707 | FL |
N | 207YS0123X | Facial Plastic Surgeon | ME46707 | FL |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | ME46707 | FL |
NPI | 1063412781 |
---|---|
Provider Name | Steven Mark Fletcher |
First Address | Homestead, FL 33033-7613 |
Second Address | Homestead, FL 33033-7613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2005 |
Last Update Date | 20/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
048348600 | (05) | FL |
D61270 | (02) | FL |