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

Stanley Dingbobga Fomban, APRN

Individual provider Family Nurse Practitioner · NPI 1639890908

Stanley Dingbobga Fomban, APRN is a Nurse Practitioner in Lutz, Florida. Qualified in 2022, 4 years ago. Practices with Baycare Medical Group, Inc, a 1,530-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
4
Licensed in
FL
In the registry since
2022
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

See every abbreviation used in this directory →

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Practice location Address checks out

4211 Van Dyke Rd Ste 200
Lutz, FL 33558-8005
Phone: (813) 321-6237
Fax: (813) 463-1801
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN11021138 (FL)

Record details

NPI number1639890908
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN
Sole proprietorNo
NPI enumeratedSeptember 6, 2022
Last updated in NPPESAugust 3, 2026
Certification dateAugust 3, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Baycare Medical Group, Inc. — 1530 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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