Provider Demographics
NPI:1215986674
Name:STOLER, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:STOLER
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 1:201 SE OSCEOLA ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2210
Mailing Address - Country:US
Mailing Address - Phone:772-286-9000
Mailing Address - Fax:772-220-4077
Practice Address - Street 1:2665 NE CYPRESS LN
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-4623
Practice Address - Country:US
Practice Address - Phone:863-287-9662
Practice Address - Fax:772-334-9239
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME35965207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53583Medicare ID - Type Unspecified
FLD64493Medicare UPIN