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Individual

DR. CAROLYN FONTANA STALVEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1600 SW ARCHER RD, BOX 100371, GAINESVILLE, FL 32610-3003
(352) 265-0301
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 265-0301

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
236694
MA
207R00000X
Internal Medicine Physician
Primary
ME105779
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2158337
MA
05
266973100
FL
Enumeration date
06/24/2006
Last updated
10/15/2010
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