Provider Demographics
NPI:1851354922
Name:STOLTZ, ROBERT B (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:STOLTZ
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 1:7050 WINKLER RD SUITE 114
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919
Mailing Address - Country:US
Mailing Address - Phone:239-489-1000
Mailing Address - Fax:239-489-0659
Practice Address - Street 1:7050 WINKLER RD SUITE 114
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919
Practice Address - Country:US
Practice Address - Phone:239-489-1000
Practice Address - Fax:239-489-0659
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH8458OtherWC
FL88209OtherBCBS
FL88209OtherBCBS
FL88209Medicare ID - Type Unspecified