Provider Demographics
NPI:1851346605
Name:STABLE, JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:STABLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 CORAL WAY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3213
Mailing Address - Country:US
Mailing Address - Phone:305-461-6060
Mailing Address - Fax:
Practice Address - Street 1:126 CENTER ST
Practice Address - Street 2:SUITE B3
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4373
Practice Address - Country:US
Practice Address - Phone:561-575-2060
Practice Address - Fax:305-461-5911
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0065447207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0065447OtherMEDICAL LICENSE
FLME0065447OtherMEDICAL LICENSE
FL25076WMedicare ID - Type Unspecified
FLF84407Medicare UPIN