Provider Demographics
NPI:1902832017
Name:POLLACK, STUART REUBEN (DC)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:REUBEN
Last Name:POLLACK
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 1:5301 GULFPORT BLVD S
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33707-4947
Mailing Address - Country:US
Mailing Address - Phone:727-321-9520
Mailing Address - Fax:727-321-9520
Practice Address - Street 1:5301 GULFPORT BLVD S
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:FL
Practice Address - Zip Code:33707-4947
Practice Address - Country:US
Practice Address - Phone:727-321-9520
Practice Address - Fax:727-321-9520
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7329111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor