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Individual

DR. ANGELA KAY STAPLETON-MACKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
400 COLONNADE DR STE 160, PONTE VEDRA, FL 32081-6236
(904) 824-1020
(904) 390-7503
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-2092
(904) 376-4075

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
113071
MO
207Q00000X
Family Medicine Physician
136291
CA
207Q00000X
Family Medicine Physician
MD60776458
WA
207Q00000X
Family Medicine Physician
Primary
ME161192
FL
207QA0505X
Adult Medicine Physician
ME161192
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
205213010
MO
01
27472051
BCBS
MO
Enumeration date
06/02/2005
Last updated
06/09/2025
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