Individual
CAITLIN NICOLE STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
450 BROOKLINE AVE, BOSTON, MA 02215-5418
(617) 632-3000
Mailing address
2520 NW 91ST DR, GAINESVILLE, FL 32606-9147
(352) 871-6773
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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