Healthcare Provider Details

I. General information

NPI: 1932775715
Provider Name (Legal Business Name): ANTHONEY FITZGAROLD STAMPP DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7041 GRAND NATIONAL DR STE 200
ORLANDO FL
32819-8380
US

IV. Provider business mailing address

5578 GREEN SHADOWS PL
ORLANDO FL
32811-2926
US

V. Phone/Fax

Practice location:
  • Phone: 407-982-7718
  • Fax: 407-704-5953
Mailing address:
  • Phone: 321-805-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: