Healthcare Provider Details

I. General information

NPI: 1902858822
Provider Name (Legal Business Name): STUART ONCOLOGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 SE OCEAN BLVD
STUART FL
34994-2573
US

IV. Provider business mailing address

433 SE OCEAN BLVD
STUART FL
34994-2573
US

V. Phone/Fax

Practice location:
  • Phone: 772-276-7242
  • Fax: 772-237-3109
Mailing address:
  • Phone: 772-276-7242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberME0064712
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: PRASHANT R PATEL
Title or Position: PRESIDENT
Credential:
Phone: 772-276-7242