| Entity Name: | BRETT E. STANALAND, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Dec 1994 (30 years ago) |
| Document Number: | P94000089479 |
| FEI/EIN Number | 593283209 |
| Address: | 1000 GOODLETTE RD N, STE 200, NAPLES, FL, 34102, US |
| Mail Address: | 1000 GOODLETTE RD N, STE 200, NAPLES, FL, 34102, US |
| ZIP code: | 34102 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710174602 | 2007-09-25 | 2008-06-03 | 1000 GOODLETTE RD N, SUITE 200, NAPLES, FL, 341025474, US | 1000 GOODLETTE RD N, SUITE 200, NAPLES, FL, 341025474, US | |||||||||||||||||||||||
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| Phone | +1 239-434-6200 |
| Fax | 2394345741 |
Authorized person
| Name | DR. BRETT E STANALAND |
| Role | PRESIDENT |
| Phone | 2394346200 |
Taxonomy
| Taxonomy Code | 207KA0200X - Allergy Physician |
| License Number | ME0062874 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS GROUP PROVIDER # |
| Number | 21957 |
| Name | Role | Address |
|---|---|---|
| BEDKE MICHAEL A | Agent | 101 KENNEDY BLVD. STE. 4100, TAMPA, FL, 33602 |
| Name | Role | Address |
|---|---|---|
| STANALAND BRETT E | Director | 1000 GOODLETTE ROAD N, SUITE 200, NAPLES, FL, 34102 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09000153887 | ALLERGY, SINUS & ASTHMA SPECIALISTS OF NAPLES | ACTIVE | 2009-09-09 | 2029-12-31 | No data | 1000 GOODLETTE ROAD N, SUITE 200, NAPLES, FL, 34102 |
| G02193900199 | ALLERGY & ASTHMA SPECIALISTS OF NAPLES | ACTIVE | 2002-07-12 | 2027-12-31 | No data | 1000 GOODLETTE ROAD N., SUITE 200, NAPLES, FL, 34102 |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
