Provider Demographics
NPI:1447390398
Name:FLINK, STEFAN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEFAN
Middle Name:
Last Name:FLINK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2691 SW PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-2848
Mailing Address - Country:US
Mailing Address - Phone:772-344-5914
Mailing Address - Fax:772-344-5915
Practice Address - Street 1:2691 SW PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-2848
Practice Address - Country:US
Practice Address - Phone:772-344-5914
Practice Address - Fax:772-344-5915
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2013-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH-7388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU69954Medicare UPIN
FL55632AMedicare ID - Type UnspecifiedPROVIDER NUMBER