Provider Demographics
NPI:1316970601
Name:STUART HEALTH ASSOCIATES PA
Entity type:Organization
Organization Name:STUART HEALTH ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:V
Authorized Official - Last Name:HANSBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC,DACAN
Authorized Official - Phone:772-287-7701
Mailing Address - Street 1:500 SE DIXIE HWY
Mailing Address - Street 2:STE 2
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3054
Mailing Address - Country:US
Mailing Address - Phone:772-287-7701
Mailing Address - Fax:772-220-4473
Practice Address - Street 1:500 SE DIXIE HWY
Practice Address - Street 2:STE 2
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3054
Practice Address - Country:US
Practice Address - Phone:772-287-7701
Practice Address - Fax:772-220-4473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3653111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty