Provider Demographics
NPI:1255495388
Name:STUHMER, CAROL A (LMT)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:STUHMER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 NE 112TH ST
Mailing Address - Street 2:
Mailing Address - City:BISCAYNE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33161-7235
Mailing Address - Country:US
Mailing Address - Phone:305-490-0106
Mailing Address - Fax:
Practice Address - Street 1:4505 W FLAGLER ST STE 202
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1500
Practice Address - Country:US
Practice Address - Phone:305-490-0106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0024491225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC7971OtherBLUE CROSS BLUE SHIELD