Maccollom, Stuart W

Maccollom, Stuart W is an individual health care provider with primary practice located at 8140 Bayhaven Dr , Seminole FL 33776-3321. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Maccollom, Stuart W can be contacted via phone (727) 546-8900.

Contact Information

Primary practice address
8140 Bayhaven Dr Seminole FL 33776-3321
Phone: (727) 546-8900
Fax: (727) 546-8940
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT2912 Florida

Profile Details

NPI number 1609063494
LBN Legal business name Maccollom, Stuart W
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2007
Last updated Mar 2nd, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609063494 NPPES
Florida MEDICAID 010475500
Florida Other AI939Y

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