Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Demetrius Stallworth

Individual provider Licensed Practical Nurse · NPI 1629506274

Demetrius Stallworth is a Licensed Practical Nurse in Orange Park, Florida. Licensed in Florida. Registered with an NPI since 2017.

Licensed in
FL
In the registry since
2017

Practice location Address checks out

490 Vineyard Ln
Orange Park, FL 32073-7678
Phone: (904) 233-2008
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence PN5192381 (FL)

Record details

NPI number1629506274
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 26, 2017
Last updated in NPPESJuly 21, 2022
Mailing address490 Vineyard Ln, Orange Park, FL 32073-7678

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