Individual
DR. CLIFFORD STUART BRISTOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17808 NE CHARLIE JOHNS ST, BLOUNTSTOWN, FL 32424-1052
(850) 674-4524
(850) 674-2300
Mailing address
17808 NE CHARLIE JOHNS ST, BLOUNTSTOWN, FL 32424-1052
(850) 674-4524
(850) 674-2300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME30535
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
059767800
—
FL
Enumeration date
02/15/2006
Last updated
03/02/2012
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