Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME72237 | MN |
Y | 207VG0400X | Gynecologist | ME72237 | FL |
NPI | 1629046990 |
---|---|
Provider Name | Dr. Christopher James Stanley |
First Address | Orlando, FL 32804-4674 |
Second Address | Orlando, FL 32804-4674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 23/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009583000 | (05) | FL |
4540390 | AETNA (01) | |
49301 | BLUE CROSS/BLUE SHIELD (01) | |
49301 | BLUE CROSS/BLUE SHIELD (01) | FL |
F81008 | (02) |