MEDICARE: DEANNA STOFFLE LPTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	20476	FL

General Provider Information

NPI Number	:	1376667758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA STOFFLE LPTA

Provider Business Mailing Address
First Line	:	2811 INDIAN CREEK DR APT B
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-4706
Country	:	US
Telephone Number	:	305-720-1473
Fax Number	:

Provider Business Practice Location Address
First Line	:	9000 SW 137TH AVE STE 116
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-1435
Country	:	US
Telephone Number	:	305-382-9991
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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Directions to “ DEANNA STOFFLE LPTA” Practice Location

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