Provider Demographics
NPI:1790369924
Name:STEWART-BATES, EMMA DELISE (OD, MS)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:DELISE
Last Name:STEWART-BATES
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2677 SW 87TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-9383
Mailing Address - Country:US
Mailing Address - Phone:352-448-3932
Mailing Address - Fax:
Practice Address - Street 1:2677 SW 87TH DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-9383
Practice Address - Country:US
Practice Address - Phone:352-448-3932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC6604152W00000X
MI4901005539152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist