Provider Demographics
NPI:1427060573
Name:STOLL, ELIZABETH ANN (DO)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:ANN
Last Name:STOLL
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1111 7TH AVE NORTH
Mailing Address - Street 2:STE. 107
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705
Mailing Address - Country:US
Mailing Address - Phone:727-894-1661
Mailing Address - Fax:727-894-1430
Practice Address - Street 1:1111 7TH AVE NORTH
Practice Address - Street 2:STE. 107
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705
Practice Address - Country:US
Practice Address - Phone:727-894-1661
Practice Address - Fax:727-894-1430
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2008-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 4017207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD84702Medicare UPIN
FL82296AMedicare PIN