Provider Demographics
NPI:1255931283
Name:CAPOTOSTI, STERLING SIMMONS (PA-C)
Entity type:Individual
Prefix:
First Name:STERLING
Middle Name:SIMMONS
Last Name:CAPOTOSTI
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 1:1813 JOSEPH CIR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6339
Mailing Address - Country:US
Mailing Address - Phone:843-615-1984
Mailing Address - Fax:
Practice Address - Street 1:1813 JOSEPH CIR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6339
Practice Address - Country:US
Practice Address - Phone:843-615-1984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant