Healthcare Provider Details

I. General information

NPI: 1225971815
Provider Name (Legal Business Name): STELLAR INFUSIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 BROOKS ST SE UNIT 101
FORT WALTON BEACH FL
32548-5887
US

IV. Provider business mailing address

1323 SE 17TH ST PMB 93310
FORT LAUDERDALE FL
33316-1707
US

V. Phone/Fax

Practice location:
  • Phone: 850-598-1042
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH JOHNSON
Title or Position: CEO
Credential:
Phone: 850-598-1042