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NPI Code Detail

MEDICARE: SANDRA KAY STAPLETON PA

MEDICARE: SANDRA KAY STAPLETON PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA9101188FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104871508
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA KAY STAPLETON PA
Provider Business Mailing Address
First Line : 6104 60TH ST E
Second Line :
City : PALMETTO
State : FL
Zip : 34221-7039
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3301 W GANDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33611-2931
Country : US
Telephone Number : 813-925-1903
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 12/11/2023

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Directions to “ SANDRA KAY STAPLETON PA” Practice Location

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