STEPHEN HORNELL, MD, PA
Dermatology at Sheridan Rd, Melbourne, FL

License number
Florida ME0024691
Category
Osteopathic Medicine
Type
Dermatology
License number
Florida ME89667
Category
Osteopathic Medicine
Type
Dermatology
License number
Florida ME85500
Category
Osteopathic Medicine
Type
Dermatology
Owner
Name: DR. STEPHEN H HORNELL MD
Title: PRESIDENT
Phone: (321) 724-9650
Address
Address
333 E Sheridan Rd, Melbourne, FL 32901
National Provider ID: 1720157696
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MELBOURNE DERMATOLOGY CENTER - STEPHEN HORNELL, M.D., PA

333 E Sheridan Rd, Melbourne, FL 32901

Status:
Inactive
Inactive reason:
NAME CHANGE AMENDMENT
Registration:
Sep 19, 1977
Inactive since:
Jul 24, 1986
State ID:
545545
Business type:
Florida Profit Corporation
Director, Secretarys:
Stephen Hornell (President, Director), 333 E Sheridan Rd, Melbourne, FL 32901 (Physical),Pamela Hornell (Director, Secretary), 106 Southgate Blvd, Melbourne, FL 32901 (Physical)
Agent:
Hornell, Stephen,106 Southgate Blvd, Melbourne, FL 32901 (Physical)
EIN:
59-1761147

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