Provider Demographics
NPI:1689615858
Name:STOPEK, RICHARD ELLIOT (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ELLIOT
Last Name:STOPEK
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 1:6311 VIA VENETIA N
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6457
Mailing Address - Country:US
Mailing Address - Phone:561-683-3600
Mailing Address - Fax:561-638-5871
Practice Address - Street 1:6311 VIA VENETIA N
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6457
Practice Address - Country:US
Practice Address - Phone:561-683-3600
Practice Address - Fax:561-638-5871
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004372111N00000X
CO4599111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT55676Medicare UPIN
88081Medicare ID - Type Unspecified