Individual
DR. ANTHONY STEWART STACK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1840 MEASE DR STE 409, SAFETY HARBOR, FL 34695-6606
(727) 443-8450
(727) 533-5911
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 315-7496
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
UO5932
FL
390200000X
Student in an Organized Health Care Education/Training Program
UO5932
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UO5932
FLORIDA TRAINING LICENSE
FL
Enumeration date
03/21/2018
Last updated
09/09/2024
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