Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | ME58011 | FL |
NPI | 1649255324 |
---|---|
Provider Name | Marshall M Stone |
First Address | Boca Raton, FL 33428-2231 |
Second Address | Boca Raton, FL 33428-2231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 24/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
063855200 | (05) | FL |
257033500 | (05) | FL |
AS1942487 | DEA NUMBER (01) | FL |
E43049 | (02) | FL |