Search › Florida › 363AS0400X
Stephen Theriault, PA-C
NPI 1134262710 · on the registry since 2007
Practice
- Address
- 1341 Medical Park Dr
Suite 201
Melbourne, FL 32901 - Phone
- (321) 953-1225
- Fax
- (321) 768-0033
- Organisation at this address
- Coastline Imaging Llc
Rehabclinics (Pta) IncInferred from a shared address, not stated in the registry. - Clinicians at this address
- 9
Registry record
- Primary taxonomy
- 363AS0400X
363AS0400X
- Also registered as
- 363AM0700X
- Licence states on file
- NH, FL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2010-01-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida