Stephen M Lange | Jacksonville, FL • PECOS Search

Stephen M Lange

Internal Medicine

Allopathic & Osteopathic Physicians

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

PECOS Enrollment

Based on the most recent information from CMS, provider Stephen M Lange does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1528057494
Provider Type
Individual
Full Name
Lange, Stephen M
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
10/13/2005
Last Updated
1/17/2023

Contact Information

Practice Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

Unlisted Fax

Mailing Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207RG0100X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License ME49066 Florida