Healthcare Provider Details

I. General information

NPI: 1669571543
Provider Name (Legal Business Name): STUART FELDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 05/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CLINT MOORE RD
BOCA RATON FL
33487-2768
US

IV. Provider business mailing address

PO BOX 850001 DEPT 991
ORLANDO FL
32886-0991
US

V. Phone/Fax

Practice location:
  • Phone: 908-653-9399
  • Fax:
Mailing address:
  • Phone: 800-248-1639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME68861
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: