Provider Demographics
NPI:1992862452
Name:STOLTZ, SCOTT ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALLEN
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 1:303 MAIN ST
Mailing Address - Street 2:#173
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-9700
Mailing Address - Country:US
Mailing Address - Phone:727-485-5428
Mailing Address - Fax:
Practice Address - Street 1:1007 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0920
Practice Address - Country:US
Practice Address - Phone:352-732-2745
Practice Address - Fax:352-732-8066
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381422001Medicare ID - Type Unspecified
FLE5276Medicare ID - Type Unspecified
FLU842850001Medicare UPIN