MEDICARE: DR. CHRISTINA EVYENIA STAMOOLIS M.D.

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	207Q00000X	Family Medicine Physician	ME106277	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01137685	OTHER	FL	RAILROAD MEDICARE PROVIDER NUMBER

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609189877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA EVYENIA STAMOOLIS M.D.

Provider Business Mailing Address
First Line	:	5332 AVION PARK DR STE 100
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1412
Country	:	US
Telephone Number	:	813-851-5050
Fax Number	:	813-738-0508

Provider Business Practice Location Address
First Line	:	5332 AVION PARK DR STE 100
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1412
Country	:	US
Telephone Number	:	813-851-5050
Fax Number	:	813-738-0508

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

Provider Enumeration Date	:	07/16/2010
Last Update Date	:	01/16/2024

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