Individual
DMITRIY STUKALOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4683 CEDRON CT, SARASOTA, FL 34240-2547
(503) 999-5016
(503) 999-5016
Mailing address
4683 CEDRON CT, SARASOTA, FL 34240-2547
(503) 999-5016
(503) 999-5016
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
05/21/2025
Last updated
05/21/2025
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