Provider Demographics
NPI:1861478695
Name:FELDMAN, STANLEY MORTON (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:MORTON
Last Name:FELDMAN
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 1:9800 WEST COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351
Mailing Address - Country:US
Mailing Address - Phone:954-475-5500
Mailing Address - Fax:954-625-8772
Practice Address - Street 1:9800 WEST COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351
Practice Address - Country:US
Practice Address - Phone:954-475-5500
Practice Address - Fax:954-625-8772
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0021477207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL93107YMedicare ID - Type UnspecifiedPROVIDER NUMBER
FLD60330Medicare UPIN
FL72882Medicare ID - Type UnspecifiedGROUP NUMBER