Provider Demographics
NPI:1407816952
Name:STAUFFER, JOHN Q (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:Q
Last Name:STAUFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 SWANN AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4038
Mailing Address - Country:US
Mailing Address - Phone:813-870-3971
Mailing Address - Fax:813-872-2644
Practice Address - Street 1:2919 W SWANN AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4038
Practice Address - Country:US
Practice Address - Phone:813-870-3971
Practice Address - Fax:813-872-2644
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0031349207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL591828425OtherTAX ID
FL591828425OtherTAX ID