1871999755 NPI number — ERIC STUMPFF D.C.

Table of content: ERIC STUMPFF D.C. (NPI 1871999755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871999755 NPI number — ERIC STUMPFF D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STUMPFF
Provider First Name:
ERIC
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871999755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7860 PETERS RD
Provider Second Line Business Mailing Address:
SUITE F-111
Provider Business Mailing Address City Name:
PLANTATION
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33324-4086
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-368-4054
Provider Business Mailing Address Fax Number:
954-769-1258

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7860 PETERS RD
Provider Second Line Business Practice Location Address:
SUITE F-111
Provider Business Practice Location Address City Name:
PLANTATION
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33324-4086
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-368-4054
Provider Business Practice Location Address Fax Number:
954-769-1258
Provider Enumeration Date:
11/05/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH 11341 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 016685000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com