Stuart Lee Wingate, PHARM.D.
Individual provider Active NPI Pharmacist · Mayport, FL
NPI 1689801037 · NPPES record last updated Aug 22, 2023
Key facts
- NPI
- 1689801037
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS 23358 (FL)
- Practice address
- 2104 Massey Ave/Naval Station
Mayport, FL 32228-0148 - Phone
- (904) 641-1207
- NPI assigned
- Jun 12, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS 23358 | FL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS 23358 | FL | Yes |
Addresses
Primary practice location
2104 Massey Ave/Naval Station
Mayport, FL 32228-0148
Mailing address
10640 Anthem Way
Jacksonville, FL 32256-4081
Phone (904) 910-9917
Other providers in Mayport, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.