Healthcare Provider Details

I. General information

NPI: 1609815539
Provider Name (Legal Business Name): FELIX ANTONIO STANZIOLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11801 SW 90TH ST SUITE 101
MIAMI FL
33186-2182
US

IV. Provider business mailing address

11801 SW 90TH ST STE 101
MIAMI FL
33186-2182
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-0719
  • Fax: 305-595-2154
Mailing address:
  • Phone: 305-595-0719
  • Fax: 305-595-2154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME0056376
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: