| Doctor Name: | MR. BRYAN MICHAEL STAFFORD |
| NPI Number: | 1194025510 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP |
| License Number: | FL ARNP9209888 |
| Business Practice Address: | 8246 River Country Dr Weeki Wachee, FL - 346072101 |
| Business Phone Number: | 3526848637 |
| Business Fax Number: | |
| Mailing Address: | 13067 Fellowship Ln, WEEKI WACHEE |
| State: | FL |
| Postal Code: | 346142977 |
| Phone Number: | 3525934281 |
| Fax Number: | |
| NPI Enumeration Date: | 11/02/2010 |
| NPI Last Update Date: | 05/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | FL ARNP9209888 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |