Provider Demographics
NPI:1578160768
Name:SCHLONEGER, STEPHEN L (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:SCHLONEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 CONWAY RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-7334
Mailing Address - Country:US
Mailing Address - Phone:407-551-3434
Mailing Address - Fax:888-440-9125
Practice Address - Street 1:3333 CONWAY RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-7334
Practice Address - Country:US
Practice Address - Phone:407-551-3434
Practice Address - Fax:888-440-9125
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1644207Q00000X
PR000325-P.A208D00000X
FLTPPA72363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLTPPA72OtherPHYSICIAN ASSISTANT TELEHEALTH