Provider Demographics
NPI:1144238031
Name:BEENA M STANLEY MD PA
Entity Type:Organization
Organization Name:BEENA M STANLEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BEENA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-860-0202
Mailing Address - Street 1:PO BOX 1255
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34451
Mailing Address - Country:US
Mailing Address - Phone:352-860-0202
Mailing Address - Fax:352-860-1918
Practice Address - Street 1:511 W HIGHLAND BLVD
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452
Practice Address - Country:US
Practice Address - Phone:352-860-0202
Practice Address - Fax:352-860-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME738912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F68559Medicare UPIN
FL42332Medicare ID - Type Unspecified