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General NPI Number Information
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NPI Number | 1386832582
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Entity Type | Organization
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Legal Business Name | MARC R STAUFFER, M.D., P.A.
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 2919 W SWANN AVE SUITE 102
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City | TAMPA
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State | FL
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Zip | 33609-4038
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Country | US
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Telephone | 813-870-3971
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Fax | 813-872-6594
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Provider Business Mailing Address
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Address Line | PO BOX 10808
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City | TAMPA
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State | FL
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Zip | 33679-0808
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Country | US
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Telephone | 813-870-3971
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Fax | 813-872-6594
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Authorized Official
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Title or Position | CEO/ PRESIDENT
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Name | MARC ROBERT STAUFFER
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Credential | MD
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Telephone | 813-870-3971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME93781
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License Number State | FL
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