Provider Demographics
NPI:1962577577
Name:PLASTIC SURGERY SPECIALISTS, PA
Entity type:Organization
Organization Name:PLASTIC SURGERY SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:STIEG
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:407-647-4601
Mailing Address - Street 1:851 W MORSE BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3708
Mailing Address - Country:US
Mailing Address - Phone:407-647-7353
Mailing Address - Fax:
Practice Address - Street 1:851 W MORSE BLVD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3708
Practice Address - Country:US
Practice Address - Phone:407-647-7353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0050906208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1764826013OtherCIGNA IRB PALS
FL623380OtherAETNA
FL13-00012OtherUNITED HEALTHCARE
FL13-00012OtherUNITED HEALTHCARE
FLD69017Medicare UPIN