Main St Medical USA

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

MAIN ST MEDICAL USA

Practice address

11734 North Dale Mabry
Tampa, FL 33618

Phone

(813) 968-6000

Fax

(813) 968-6007

NPI assigned

Apr 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephen Allen Stefano, MD

Title

Director MD

Phone

(813) 968-6000

Specialties & licenses 3

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1003039033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11734 NORTH DALE MABRY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33618",
            "telephone_number": "813-968-6000",
            "fax_number": "813-968-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11734 NORTH DALE MABRY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33618",
            "telephone_number": "813-968-6000",
            "fax_number": "813-968-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN ST MEDICAL USA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "STEFANO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "DIRECTOR MD",
        "authorized_official_telephone_number": "813-968-6000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristina Maiden, APRN, FNP-C
• Katrina Maier
• Robin Maier, LCSW
• Rachel Mailliard
• Main Rehab Center LLC
• Main Street Medical LLC (Main Street Medical Centers)
• Ritika Maini, RBT
• Anna Marie Mainiero
• Manda Emeline Mainville, DO
• Angela M Maio, MD

• Addiction Medicine (Internal Medicine) Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Addiction Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.