Provider Demographics
NPI:1932448289
Name:STEPHEN L. HELGEMO, JR., M.D., P.A.
Entity type:Organization
Organization Name:STEPHEN L. HELGEMO, JR., M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HELGEMO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:941-625-6547
Mailing Address - Street 1:18344 MURDOCK CIR
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1008
Mailing Address - Country:US
Mailing Address - Phone:941-625-6547
Mailing Address - Fax:941-629-6415
Practice Address - Street 1:13710 METROPOLIS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-7144
Practice Address - Country:US
Practice Address - Phone:941-625-6547
Practice Address - Fax:941-629-6415
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPHEN L. HELGEMO, JR., M.D., P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-06
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72747207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDE0280OtherRAILROAD MEDICARE
FLK8187Medicare PIN
FL1306740001Medicare PIN
FLDE0280OtherRAILROAD MEDICARE
FLK8187AMedicare PIN