Provider Demographics
NPI:1528025780
Name:STOPCZYNSKI, GERALD E (DO)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:E
Last Name:STOPCZYNSKI
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 1:3226 NW 123RD AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3022
Mailing Address - Country:US
Mailing Address - Phone:954-229-0926
Mailing Address - Fax:954-572-0298
Practice Address - Street 1:3226 NW 123RD AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3022
Practice Address - Country:US
Practice Address - Phone:954-229-0926
Practice Address - Fax:954-572-0298
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS3583207P00000X, 207Q00000X
MI009505207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD27345Medicare UPIN