Provider Demographics
NPI:1285470013
Name:STOPPENBACH, KARI
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:STOPPENBACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 CARLSON DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-1203
Mailing Address - Country:US
Mailing Address - Phone:407-443-3173
Mailing Address - Fax:
Practice Address - Street 1:407 LAKE HOWELL RD STE 1005
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5911
Practice Address - Country:US
Practice Address - Phone:407-443-3173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL48-BID-7038048246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other