Provider Demographics
NPI:1013920305
Name:STEWART, CAROL ANDREA
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANDREA
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:ANDREA
Other - Last Name:STEWART-FRANCISCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:140 N WESTMONTE DR STE 1000
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3303
Mailing Address - Country:US
Mailing Address - Phone:407-862-4500
Mailing Address - Fax:407-862-1173
Practice Address - Street 1:140 N WESTMONTE DR STE 1000
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3303
Practice Address - Country:US
Practice Address - Phone:407-862-4500
Practice Address - Fax:407-862-1173
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88668207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2262YOtherWELLMED MEDICAL MANAGEMENT OF FLORIDA INC
FL269405100Medicaid
FLI06188Medicare UPIN
FLK5494Medicare ID - Type Unspecified