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General NPI Number Information
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NPI Number | 1366989105
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Entity Type | Organization
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Legal Business Name | STEMEDIX, INC
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 10/07/2022
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Provider Practice Location Address
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Address Line | 601 7TH ST S STE 565
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4708
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Country | US
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Telephone | 727-456-8968
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Fax | 727-362-4630
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Provider Business Mailing Address
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Address Line | 601 7TH ST S STE 565
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4708
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Country | US
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Telephone | 727-456-8968
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Fax | 727-362-4630
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Authorized Official
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Title or Position | DIRECTOR
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Name | FRED PALMER
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Credential |
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Telephone | 727-456-8968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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