Provider Demographics
NPI:1073758371
Name:FELIX A STANZIOLA, MD, PA
Entity Type:Organization
Organization Name:FELIX A STANZIOLA, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:A
Authorized Official - Last Name:STANZIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-595-0719
Mailing Address - Street 1:11801 SW 90TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2182
Mailing Address - Country:US
Mailing Address - Phone:305-595-0719
Mailing Address - Fax:305-595-2154
Practice Address - Street 1:11801 SW 90TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2182
Practice Address - Country:US
Practice Address - Phone:305-595-0719
Practice Address - Fax:305-595-2154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14520Medicare PIN