Provider Demographics
NPI:1568481224
Name:MILLSTONE, STUART Z (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:Z
Last Name:MILLSTONE
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 1:1893 KINGSLEY AVE
Mailing Address - Street 2:STE C
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4491
Mailing Address - Country:US
Mailing Address - Phone:904-276-2044
Mailing Address - Fax:904-276-2106
Practice Address - Street 1:1893 KINGSLEY AVE
Practice Address - Street 2:STE C
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4491
Practice Address - Country:US
Practice Address - Phone:904-276-2044
Practice Address - Fax:904-276-2106
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39842207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL041856100Medicaid
FL15727ZMedicare ID - Type Unspecified
FL041856100Medicaid