Provider Demographics
NPI:1598773434
Name:STAHLER, DAVID CHARLES
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:STAHLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 N MILLS AVENUE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803
Mailing Address - Country:US
Mailing Address - Phone:407-841-7151
Mailing Address - Fax:407-648-2259
Practice Address - Street 1:1745 N MILLS AVENUE
Practice Address - Street 2:CENTRAL FLORIDA CARDIOLOGY GROUP
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803
Practice Address - Country:US
Practice Address - Phone:407-841-7151
Practice Address - Fax:407-648-2259
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA1644363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS53059Medicare UPIN