Provider Demographics
NPI:1851389472
Name:STELNICKI, JAMES V (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:V
Last Name:STELNICKI
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 1:6543 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
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO000387213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL561650OtherSELECT CARE
FL0071853OtherGHI
FL632795OtherFRREDOM ADVANTA
FL87150OtherBLUE CROSS BLUE SHIELD
FL201971OtherAMERIGROUP
FL201971OtherAMERIGROUP
FLT55347Medicare UPIN