Provider Demographics
NPI:1437562048
Name:ELBERG, STELLA (DO)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:
Last Name:ELBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 NW 87TH AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1604
Mailing Address - Country:US
Mailing Address - Phone:305-653-5155
Mailing Address - Fax:
Practice Address - Street 1:2801 NW 87TH AVE STE 5
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1604
Practice Address - Country:US
Practice Address - Phone:305-653-5155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 12726207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine