Provider Demographics
NPI:1508865924
Name:STANALAND, BRETT E (MD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:E
Last Name:STANALAND
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 1:1000 GOODLETTE RD N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5474
Mailing Address - Country:US
Mailing Address - Phone:239-434-6200
Mailing Address - Fax:239-434-5741
Practice Address - Street 1:1000 GOODLETTE RD N
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5474
Practice Address - Country:US
Practice Address - Phone:239-434-6200
Practice Address - Fax:239-434-5741
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0062874207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
26815OtherBLUE CROSS PROVIDER #
FL378659500Medicaid
26815YMedicare PIN
FL378659500Medicaid