Provider Demographics
NPI:1285074252
Name:STAFFELBACH, PAUL CHARLES II
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:CHARLES
Last Name:STAFFELBACH
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 SW 37TH AVE
Mailing Address - Street 2:APT PH-1
Mailing Address - City:COCONUT GROVE
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2743
Mailing Address - Country:US
Mailing Address - Phone:786-290-4186
Mailing Address - Fax:
Practice Address - Street 1:169 E FLAGLER ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-1210
Practice Address - Country:US
Practice Address - Phone:305-573-3784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)