Provider Demographics
NPI:1194075747
Name:STUART ZOLL CA OMD PA
Entity type:Organization
Organization Name:STUART ZOLL CA OMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:ZOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-395-2667
Mailing Address - Street 1:7301 W PALMETTO PARK RD STE 103C
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3455
Mailing Address - Country:US
Mailing Address - Phone:561-395-2667
Mailing Address - Fax:
Practice Address - Street 1:7301 W PALMETTO PARK RD STE 103C
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3455
Practice Address - Country:US
Practice Address - Phone:561-395-2667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL267171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty