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General NPI Number Information
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NPI Number | 1215535794
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Entity Type | Organization
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Legal Business Name | STANKUS FAMILY CARE
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 18743 NW 234TH ST
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City | HIGH SPRINGS
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State | FL
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Zip | 32643-0465
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Country | US
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Telephone | 352-214-5807
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Fax |
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Provider Business Mailing Address
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Address Line | 18743 NW 234TH ST
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City | HIGH SPRINGS
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State | FL
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Zip | 32643-0465
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH STANKUS
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Credential | APRN
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Telephone | 352-214-5807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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