Provider Demographics
NPI:1689696601
Name:COURTNEY, STUART ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:ALAN
Last Name:COURTNEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE 1005A
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4636
Mailing Address - Country:US
Mailing Address - Phone:954-458-2228
Mailing Address - Fax:954-458-2530
Practice Address - Street 1:1250 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 1005A
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4636
Practice Address - Country:US
Practice Address - Phone:954-458-2228
Practice Address - Fax:954-458-2530
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO745213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87502Medicare PIN
T55438Medicare UPIN