Healthcare Provider Details

I. General information

NPI: 1285570085
Provider Name (Legal Business Name): MOLLY ELISE STOUT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 BELVEDERE RD
ROYAL PALM BEACH FL
33411-3640
US

IV. Provider business mailing address

4256 NE SUNSET DR
JENSEN BEACH FL
34957-3851
US

V. Phone/Fax

Practice location:
  • Phone: 561-309-9070
  • Fax:
Mailing address:
  • Phone: 561-309-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: