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Individual
MR. STEPHEN MICHAEL STAUDT JR.
Active
Individual
MR. STEPHEN MICHAEL STAUDT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9111157
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14366545
CAQH
FL
01
—
PA9111157
STATE OF FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
10/25/2018
Last updated
11/15/2018
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