Provider Demographics
NPI:1992468904
Name:STONE, DEVORA LEAH (PA-C)
Entity Type:Individual
Prefix:
First Name:DEVORA
Middle Name:LEAH
Last Name:STONE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1192 E NEWPORT CENTER DR
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-7753
Mailing Address - Country:US
Mailing Address - Phone:954-698-3687
Mailing Address - Fax:954-698-3681
Practice Address - Street 1:1192 E NEWPORT CENTER DR
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-7753
Practice Address - Country:US
Practice Address - Phone:954-698-3687
Practice Address - Fax:954-698-3681
Is Sole Proprietor?:No
Enumeration Date:2021-10-17
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9115140363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant