Provider Demographics
NPI:1285616227
Name:STANLEY S MOLES & ASSOCIATES MD'S PA
Entity type:Organization
Organization Name:STANLEY S MOLES & ASSOCIATES MD'S PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEB
Authorized Official - Middle Name:J
Authorized Official - Last Name:GARDINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-581-6984
Mailing Address - Street 1:1345 W BAY DR
Mailing Address - Street 2:STE 301
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2282
Mailing Address - Country:US
Mailing Address - Phone:727-581-6984
Mailing Address - Fax:727-584-7648
Practice Address - Street 1:1345 W BAY DR
Practice Address - Street 2:STE 301
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-2282
Practice Address - Country:US
Practice Address - Phone:727-581-6984
Practice Address - Fax:727-584-7648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
Not Answered2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
Not Answered2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL97819Medicare ID - Type Unspecified