STEPAN OLIVA (NPI# 1316019334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316019334 |
| Entity Type | Individual |
| Full Name | STEPAN OLIVA |
| Credential | MD |
| Practice Address |
560 Avenue K Se Winter Haven FL 33880-4203 |
| Practice Telephone | 8632993376 |
| Mailing Telephone | 8632993376 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2009-07-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | ME75639 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | P00397643 | 01 |
| FL | BLUE CROSS BLUE SHIELD OF FLORIDA | 43555 | 01 |
| Street Address |
560 AVENUE K SE |
| City | WINTER HAVEN |
| State | FL |
| Zip Code | 33880-4203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508863416 | Howard C Lucas | Ophthalmology | 560 Avenue K Se, Winter Haven, Winter Haven, FL 33880-4203 | 2005-07-07 |
| 1326373341 | Howard Lucas Md Pa | Ophthalmology | 560 Avenue K Se, Winter Haven, FL 33880-4203 | 2009-10-08 |
| 1528278363 | Winter Haven Dermatology Pa | Dermatology | 560 Avenue K Se, Winter Haven, FL 33880-4203 | 2007-05-23 |
| 1942272802 | Kate Gwendolyn Ryals | Physician Assistant | 560 Avenue K Se, Winter Haven, FL 33880-4203 | 2006-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851896955 | Cheryl Gonzalez | Physical Therapy Assistant | 1601 6th Street Swe, Winter Haven, FL 33880 | 2018-03-29 |
| 1265950661 | Integrity Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 135 1st Street South, Winter Haven, FL 33880 | 2017-09-06 |
| 1912423427 | Stacy Lewis | Counselor | 1943 Ave E Sw, Winter Haven, FL 33880 | 2017-08-16 |
| 1497275952 | Kleine Pediatrics | Pediatrics | 375 E Central Avenue, Suite 391, Winter Haven, FL 33880 | 2017-06-26 |
| 1255851457 | Farah N Habib | Dentist | 375 E Central Ave, Suite 361, Winter Haven, FL 33880 | 2017-06-20 |
| 1356878086 | Congruent Hearts Companions | Home Health | 111 Ave R N.e., Winter, FL 33880 | 2017-05-12 |
| 1689033201 | Jason Acosta | General Practice | 111 Avenue A Se, Winter Haven, FL 33880 | 2016-02-11 |
| 1629440573 | National Vision, Inc. | Technician/Technologist | 341 & 343 Cypress Gardens Blvd, Winter Haven, FL 33880 | 2015-10-30 |
| 1518336825 | Nicole A. Domenech | General Practice | 950 First St. South, Winter Haven, FL 33880 | 2015-09-16 |
| 1447666417 | Lee Tramell Vickers | Pharmacist | 701 1st Street, Winter Haven, FL 33880 | 2014-07-10 |
| Find all providers in zip 33880 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316953912 | Nelson Alfred Warner | Dermatology | 429 2nd St Nw, Winter Haven, FL 33881-4168 | 2006-08-01 |
| 1730146564 | Klaus F. Sellheyer | Dermatology | 1450 6th St Se, Winter Haven, FL 33880-4505 | 2006-04-26 |
| 1780846667 | Roya Ghorsriz | Dermatology | 635 1st St N, Winter Haven, FL 33881-4191 | 2008-07-01 |
| 1346447109 | Nelson A Warner Md Pa | Dermatology | 429 2nd St Nw, Winter Haven, FL 33881-4168 | 2007-06-27 |
| 1528278363 | Winter Haven Dermatology Pa | Dermatology | 560 Avenue K Se, Winter Haven, FL 33880-4203 | 2007-05-23 |
| 1174574941 | Rebecca C. Tung | Dermatology | 1450 6th St Se, Winter Haven, FL 33880-4505 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002154 | Precision Skin LLC | Dermatology | 3501 S University Dr Ste 5, Davie, FL 33328-2001 | 2020-10-28 |
| 1487252417 | Janice Reaume | Dermatology | 3335 Imperial Manor Way, Mulberry, FL 33860-5519 | 2020-10-12 |
| 1922617729 | Synergymd, LLC | Dermatology | 1208 E Kennedy Blvd Ste 221, Tampa, FL 33602-3509 | 2020-07-28 |
| 1518585447 | Alexander F Wong | Dermatology | 1300 Goodlette-frank Rd N, Naples, FL 34102-5243 | 2020-07-07 |
| 1508495003 | Elite Dermatology | Dermatology | 401 Coral Way Ste 207, Coral Gables, FL 33134-4924 | 2020-04-06 |
| 1124668371 | Meaghan Margaret Birakis | Dermatology | 3319 Fl-7 #202, Wellington, FL 33449 | 2020-01-15 |
| 1396380044 | Suzanne Marie Smith | Dermatology | 21097 Ne 27th Ct Ste 500, Miami, FL 33180-1235 | 2019-11-15 |
| 1376188383 | Enchantress Dermatology, Inc. | Dermatology | 241 Nw 119 Ave, Miami, FL 33182-1329 | 2019-11-13 |
| 1699319988 | Revivify Dermatology, LLC | Dermatology | 21301 Powerline Rd # 108, Boca Raton, FL 33433-2388 | 2019-10-30 |
| 1841833928 | Carly Marie Maher | Dermatology | 90 Cypress Way E Ste 50, Naples, FL 34110-9275 | 2019-10-22 |
| Find all providers with the same taxonomy | ||||
| City | WINTER HAVEN |
| Zip Code | 33880 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.