Stambo, Glenn William

Stambo, Glenn William is an individual health care provider with primary practice located at 4516 N Armenia Ave , Tampa FL 33603-2732. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Stambo, Glenn William can be contacted via phone (813) 348-6951.

Contact Information

Primary practice address
4516 N Armenia Ave Tampa FL 33603-2732
Phone: (813) 348-6951
Fax: (813) 348-6999
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME76556 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME76556 Florida

Profile Details

NPI number 1003881350
LBN Legal business name Stambo, Glenn William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Mar 26th, 2010 - about 14 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 1003881350 NPPES
Florida Other 300130409 RR MCR
Florida MEDICAID 254668000 RR MCR

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