Provider Demographics
NPI:1730145608
Name:STANCIU, SEBASTIAN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:SEBASTIAN
Middle Name:ROBERT
Last Name:STANCIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 55009
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-0009
Mailing Address - Country:US
Mailing Address - Phone:912-335-6943
Mailing Address - Fax:904-398-5617
Practice Address - Street 1:2122 UNIVERSITY BLVD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8937
Practice Address - Country:US
Practice Address - Phone:904-398-5614
Practice Address - Fax:904-398-5617
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89939207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG099441597OtherGEORGIA MEDICARE PALMETTO GBA
FL273691800Medicaid
FL03409ZMedicare PIN