Provider Demographics
NPI:1295820793
Name:STINSON, HAROLD SENTRE JR (DO)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:SENTRE
Last Name:STINSON
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:HAROLD
Other - Middle Name:SENTRE
Other - Last Name:STINSON
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:11373 SW 211 STREET
Mailing Address - Street 2:SUITE 16
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189
Mailing Address - Country:US
Mailing Address - Phone:305-234-0009
Mailing Address - Fax:305-367-4833
Practice Address - Street 1:11373 SW 211 STREET
Practice Address - Street 2:SUITE 16
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33189
Practice Address - Country:US
Practice Address - Phone:305-234-0009
Practice Address - Fax:305-367-4833
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6140207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056119300Medicaid
FL056119300Medicaid
FL80554Medicare ID - Type Unspecified