Individual
FREDERICK E STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7955 SPYGLASS HILL RD STE A, MELBOURNE, FL 32940-8249
(321) 255-6670
(321) 242-2545
Mailing address
7955 SPYGLASS HILL RD STE A, MELBOURNE, FL 32940-8249
(321) 255-6670
(321) 242-2545
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108629
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9108629
FL PA LICENSE
FL
Enumeration date
04/09/2007
Last updated
12/29/2015
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