Organization
SIGNATURE COORDINATION & CONSULT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEA G STONOM (OWNER)
(954) 899-0954
Entity
Organization
Contact information
Practice address
1221 DELAWARE AVE FL 2, FORT PIERCE, FL 34950-4084
(954) 899-0954
Mailing address
1221 DELAWARE AVE FL 2, FORT PIERCE, FL 34950-4084
(954) 899-0954
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110134800
—
FL
Enumeration date
02/13/2022
Last updated
02/13/2022
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