Individual
THOMAS GERALD STAVOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1890 LPGA BLVD, STE. 160, DAYTONA BEACH, FL 32117-7130
(386) 252-4701
(386) 253-9410
Mailing address
1890 LPGA BLVD, STE. 160, DAYTONA BEACH, FL 32117-7130
(386) 252-4701
(386) 253-9410
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME54029
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00551
BC BS
—
05
—
049302300
—
FL
01
—
4055441
AETNA
—
Enumeration date
03/10/2006
Last updated
05/16/2012
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