Provider Demographics
NPI:1932775715
Name:STAMPP, ANTHONEY FITZGAROLD (DO)
Entity Type:Individual
Prefix:
First Name:ANTHONEY
Middle Name:FITZGAROLD
Last Name:STAMPP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5578 GREEN SHADOWS PL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-2926
Mailing Address - Country:US
Mailing Address - Phone:321-805-9700
Mailing Address - Fax:
Practice Address - Street 1:7041 GRAND NATIONAL DR STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8380
Practice Address - Country:US
Practice Address - Phone:407-982-7718
Practice Address - Fax:407-704-5953
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10952419OtherPSR