Provider Demographics
NPI:1144423351
Name:STEELE, GAREN DAXTON (MD)
Entity type:Individual
Prefix:DR
First Name:GAREN
Middle Name:DAXTON
Last Name:STEELE
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:PO BOX 30532
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-1532
Mailing Address - Country:US
Mailing Address - Phone:850-916-3700
Mailing Address - Fax:850-916-3710
Practice Address - Street 1:1040 GULF BREEZE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-7809
Practice Address - Country:US
Practice Address - Phone:850-916-3700
Practice Address - Fax:850-916-3710
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-00137207X00000X
FLME114795207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911565Medicaid
FL008151400Medicaid
FL14P25OtherFLORIDA BLUE
AL593-11041OtherBLUE CROSS BLUE SHIELD
AL145041Medicaid
AL593-11042OtherBLUE CROSS BLUE SHIELD
AL145220Medicaid
FL008151400Medicaid
FLGX762ZMedicare PIN
NC2073322Medicare PIN