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Individual

THOMAS PAUL STANLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
2606 PARK ST., JACKSONVILLE, FL 32204
(904) 388-4646
(904) 388-9017
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(904) 388-4646
(904) 388-9017

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME 0057822
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0643840-00
FL
Enumeration date
01/30/2006
Last updated
04/22/2021
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