Stephen Mudra

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME40369 Issued in FL

Practice address

1130 NW 64TH Ter
Gainesville, FL 32605-4219

Phone

(352) 333-5242

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114945284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 NW 64TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054219",
            "telephone_number": "352-333-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 NW 64TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054219",
            "telephone_number": "352-333-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDRA",
        "first_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME40369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David W Mozingo, MD
• Shanice Fontrell Mucher
• Jonathan S. Muchnick, MD
• Ashley Klaczak Mudra, PA-C
• Nicholas Andrew Mudra, PHYSICIAN ASSISTANT
• Marcus Muehlbauer, M.D.
• Brooke T Mueller, PHARMD
• Bruce A Mueller, OTR/L, CHT
• Devon R Mueller, PHARMD
• Maribel Mueller, CRNA

• Internal Medicine Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.