Provider Demographics
NPI:1548302557
Name:GUBERMAN, STAN HOWARD (DC)
Entity type:Individual
Prefix:DR
First Name:STAN
Middle Name:HOWARD
Last Name:GUBERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7051 W COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 3-C
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2146
Mailing Address - Country:US
Mailing Address - Phone:954-722-8086
Mailing Address - Fax:954-726-6899
Practice Address - Street 1:7051 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 3-C
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-2146
Practice Address - Country:US
Practice Address - Phone:954-722-8086
Practice Address - Fax:954-726-6899
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0002715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor