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General NPI Number Information
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NPI Number | 1649209842
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Entity Type | Individual
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Provider Name | ELENA STANESCU MD
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Gender | Female
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 105 SOUTHPARK BLVD SUITE C-300
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-4162
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Country | US
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Telephone | 904-808-7246
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Fax | 904-808-7090
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Provider Business Mailing Address
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Address Line | 105 SOUTHPARK BLVD SUITE C-300
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-4162
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Country | US
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Telephone | 904-808-7246
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Fax | 904-808-7090
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | ME76186
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License Number State | FL
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