Provider Demographics
NPI:1376517490
Name:STIMLER, JOHN ERNEST (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ERNEST
Last Name:STIMLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2279 SEMINOLE RD.
Mailing Address - Street 2:#5
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233
Mailing Address - Country:US
Mailing Address - Phone:904-241-5216
Mailing Address - Fax:
Practice Address - Street 1:2279 SEMINOLE RD
Practice Address - Street 2:#5
Practice Address - City:ATLANTIC BEACH
Practice Address - State:FL
Practice Address - Zip Code:32233-5982
Practice Address - Country:US
Practice Address - Phone:904-241-5216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS3639207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD84664Medicare UPIN
FL85088WMedicare PIN