Provider Demographics
NPI:1003275967
Name:STEHR, JANEIL L (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JANEIL
Middle Name:L
Last Name:STEHR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 71ST ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-2972
Mailing Address - Country:US
Mailing Address - Phone:305-868-9905
Mailing Address - Fax:305-868-9965
Practice Address - Street 1:1040 71ST ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-2972
Practice Address - Country:US
Practice Address - Phone:305-868-9905
Practice Address - Fax:305-868-9965
Is Sole Proprietor?:No
Enumeration Date:2016-02-19
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210066225100000X
FLPT 32357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC05954OtherMEDICARE GROUP PTAN
VA1003275967OtherMEDICAID QMB ONLY
FL1003275967OtherMEDICAID QMB ONLY
VAC05954OtherMEDICARE GROUP PTAN
VAC05954OtherMEDICARE GROUP PTAN
VAQ52922AMedicare PIN