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General NPI Number Information
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NPI Number | 1144030727
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Entity Type | Individual
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Provider Name | MADISON STANFORD PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 3009 SW WILLISTON RD
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City | GAINESVILLE
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State | FL
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Zip | 32608-3928
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Country | US
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Telephone | 352-294-5400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100236
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City | GAINESVILLE
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State | FL
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Zip | 32610-0236
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Country | US
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Telephone | 352-273-5550
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Fax | 352-273-5575
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9119255
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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