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Individual

MICHAEL PHILIP STOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
14226 CHEVAL MAYFAIRE DR APT 102, ORLANDO, FL 32828-7617
(407) 272-1634
Mailing address
14226 CHEVAL MAYFAIRE DR APT 102, ORLANDO, FL 32828-7617
(407) 272-1634

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
S330555752550
FL

Other

Enumeration date
06/20/2013
Last updated
06/20/2013
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