Healthcare Provider Details

I. General information

NPI: 1235494493
Provider Name (Legal Business Name): CALEB MANESS STALLS MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

IV. Provider business mailing address

1316 THE PRESERVE TRL
CHAPEL HILL NC
27517-7690
US

V. Phone/Fax

Practice location:
  • Phone: 305-666-6511
  • Fax:
Mailing address:
  • Phone: 919-696-0237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME141381
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberME141381
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: