Provider Demographics
NPI:1215084215
Name:NEDD, STEPHEN ALAN (DC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ALAN
Last Name:NEDD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-4908
Mailing Address - Country:US
Mailing Address - Phone:727-467-0775
Mailing Address - Fax:727-467-0774
Practice Address - Street 1:1221 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-4908
Practice Address - Country:US
Practice Address - Phone:727-467-0775
Practice Address - Fax:727-467-0774
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UO6561Medicare UPIN
FL22583Medicare ID - Type Unspecified