Provider Demographics
NPI:1316935257
Name:STOCK, MARGARET ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:STOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 GRANDY AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-6112
Mailing Address - Country:US
Mailing Address - Phone:904-398-5561
Mailing Address - Fax:904-398-8229
Practice Address - Street 1:1445 DUNN AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-1437
Practice Address - Country:US
Practice Address - Phone:386-323-0550
Practice Address - Fax:386-323-0510
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85321207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269381000Medicaid
FL269381000Medicaid
FL82238ZMedicare ID - Type Unspecified