Provider Demographics
NPI:1447926316
Name:SAINTELUS, STANLEY (PA-C)
Entity type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:
Last Name:SAINTELUS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 LAKE MONTEREY CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8436
Mailing Address - Country:US
Mailing Address - Phone:561-271-4715
Mailing Address - Fax:
Practice Address - Street 1:1421 S RANGE LINE RD
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801-5589
Practice Address - Country:US
Practice Address - Phone:417-434-9445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024013598363A00000X
FLPA9114962363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant