Provider Demographics
NPI:1407246838
Name:STEWART, FELMER (APRN)
Entity type:Individual
Prefix:
First Name:FELMER
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-361-5565
Mailing Address - Fax:
Practice Address - Street 1:2329 MEDICO LN STE 101
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8449
Practice Address - Country:US
Practice Address - Phone:321-361-5565
Practice Address - Fax:321-434-9530
Is Sole Proprietor?:No
Enumeration Date:2015-01-23
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020146363LA2200X, 363L00000X
WVAPRN63085NP363L00000X
AZAP9693363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116546500Medicaid
FLQB596OtherHF MA
FLQB596OtherHF MA