Provider Demographics
NPI:1780854877
Name:JAMES V STELNICKI DPM PA
Entity Type:Organization
Organization Name:JAMES V STELNICKI DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:V
Authorized Official - Last Name:STELNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-842-9504
Mailing Address - Street 1:6543 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-1926
Mailing Address - Country:US
Mailing Address - Phone:727-842-9504
Mailing Address - Fax:727-842-9505
Practice Address - Street 1:6543 MADISON ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-1926
Practice Address - Country:US
Practice Address - Phone:727-842-9504
Practice Address - Fax:727-842-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO000387213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100898800Medicaid
DEDF098AOtherMEDICARE PTAN
FLDR3122OtherMEDICARE RAILROAD CARRIER GROUP PTAN
FL480033991OtherRAILROAD MEDICARE