Provider Demographics
NPI:1891996484
Name:STIRLING SPINAL HEALTH AND WELLNESS PA
Entity Type:Organization
Organization Name:STIRLING SPINAL HEALTH AND WELLNESS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:OUELLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-392-7700
Mailing Address - Street 1:9710 STIRLING RD
Mailing Address - Street 2:112
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8018
Mailing Address - Country:US
Mailing Address - Phone:954-392-7700
Mailing Address - Fax:954-392-7711
Practice Address - Street 1:9710 STIRLING RD
Practice Address - Street 2:112
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8018
Practice Address - Country:US
Practice Address - Phone:954-392-7700
Practice Address - Fax:954-392-7711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8246111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70274Medicare ID - Type Unspecified