Provider Demographics
NPI:1538138573
Name:SHTULMAN, HOWARD (DC)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:SHTULMAN
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 1:4507 N PINE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5321
Mailing Address - Country:US
Mailing Address - Phone:954-741-6233
Mailing Address - Fax:954-742-0583
Practice Address - Street 1:4507 N PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-5321
Practice Address - Country:US
Practice Address - Phone:954-741-6233
Practice Address - Fax:954-742-0583
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3802825000Medicaid
FLCH0004066OtherCHIROPRACTIC LICENSE
FLT84436Medicare UPIN
FL3802825000Medicaid