Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | OS7178 | FL |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | OS7178 | FL |
NPI | 1902888217 |
---|---|
Provider Name | Michael Stampar |
First Address | Punta Gorda, FL 33950-4450 |
Second Address | Punta Gorda, FL 33950-4450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 19/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A76652 | (02) | FL |