Healthcare Provider Details

I. General information

NPI: 1649255324
Provider Name (Legal Business Name): MARSHALL M STONE M.D,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 03/07/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 S OLD DIXIE HWY STE 101
JUPITER FL
33458-7202
US

IV. Provider business mailing address

1002 S OLD DIXIE HWY STE 101
JUPITER FL
33458-7202
US

V. Phone/Fax

Practice location:
  • Phone: 561-852-0038
  • Fax: 561-852-2261
Mailing address:
  • Phone: 561-852-0038
  • Fax: 561-852-2261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberME58011
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: