MEDICARE: MRS. TONI-ANN STANSELL

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
1	222Q00000X	Developmental Therapist
2	104100000X	Social Worker		FL

Other Identifiers

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

General Provider Information

NPI Number	:	1447378203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TONI-ANN STANSELL

Provider Business Mailing Address
First Line	:	2433 BRUNELLO TRCE
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-7800
Country	:	US
Telephone Number	:	727-834-5428
Fax Number	:	813-949-7535

Provider Business Practice Location Address
First Line	:	2433 BRUNELLO TRCE
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-7800
Country	:	US
Telephone Number	:	727-834-5428
Fax Number	:	813-949-7535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	07/21/2011

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