Healthcare Provider Details

I. General information

NPI: 1033040969
Provider Name (Legal Business Name): DEBORAH LEE DAY STORY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 EXUMA WAY APT 318
SANTA ROSA BEACH FL
32459-7061
US

IV. Provider business mailing address

261 EXUMA WAY APT 318
SANTA ROSA BEACH FL
32459-7061
US

V. Phone/Fax

Practice location:
  • Phone: 731-693-0026
  • Fax:
Mailing address:
  • Phone: 731-693-0026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11047566
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: