Individual
LEA G STONOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5322 NW LAMOORE LN, PORT SAINT LUCIE, FL 34983-5334
(772) 480-2737
Mailing address
5322 NW LAMOORE LN, PORT SAINT LUCIE, FL 34983-5334
(772) 480-2737
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
012815600
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012815600
—
FL
Enumeration date
02/04/2022
Last updated
02/04/2022
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