Healthcare Provider Details

I. General information

NPI: 1518877141
Provider Name (Legal Business Name): STEPHANIA CULMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 NW 12TH AVE
FORT LAUDERDALE FL
33309-1146
US

IV. Provider business mailing address

3436 GARDEN LN
MIRAMAR FL
33023-4970
US

V. Phone/Fax

Practice location:
  • Phone: 954-890-1785
  • Fax:
Mailing address:
  • Phone: 305-761-9923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: