Healthcare Provider Details

I. General information

NPI: 1568432375
Provider Name (Legal Business Name): CARRIE MAE STONEKING D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38021 MARKET SQ
ZEPHYRHILLS FL
33542-7504
US

IV. Provider business mailing address

2600 WESTHALL LANE BOX 300
MAITLAND FL
32751
US

V. Phone/Fax

Practice location:
  • Phone: 813-715-0374
  • Fax: 813-355-5090
Mailing address:
  • Phone: 407-200-2807
  • Fax: 407-200-1353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS12096
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: