Individual
LEAH JACQUELINE STUBBLEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5880 49TH ST N, STE 104, ST PETERSBURG, FL 33709-2150
(727) 528-6100
(727) 528-7895
Mailing address
5880 49TH ST N, STE 104, ST PETERSBURG, FL 33709-2150
(727) 528-6100
(727) 528-7895
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA910479
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001677500
—
FL
01
—
AL867Y
MEDICARE PTAN
FL
Enumeration date
06/11/2008
Last updated
03/17/2018
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