Organization
CENTRAL FLORIDA OTOLARYNGOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MENACHEM M STUART MD (OWNER)
(863) 225-6522
Entity
Organization
Contact information
Practice address
410 LIONEL WAY, STE 202, DAVENPORT, FL 33837
(863) 225-6522
(863) 582-9796
Mailing address
410 LIONEL WAY, STE 202, DAVENPORT, FL 33837
(863) 225-6522
(863) 582-9796
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME112526
STATE MEDICAL LICENSE
FL
Enumeration date
03/29/2012
Last updated
03/29/2012
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