Healthcare Provider Details

I. General information

NPI: 1700825809
Provider Name (Legal Business Name): MIKE M STOICI D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 04/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 DR MARTIN LUTHER KING JR ST N
ST PETERSBURG FL
33702-1108
US

IV. Provider business mailing address

1000 SUMMERSET DR
PITTSBURGH PA
15217-2535
US

V. Phone/Fax

Practice location:
  • Phone: 727-525-4499
  • Fax:
Mailing address:
  • Phone: 412-519-9335
  • Fax: 724-837-7511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS036341
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN18434
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: