Healthcare Provider Details

I. General information

NPI: 1831584697
Provider Name (Legal Business Name): HOWARD ALLAN STOLLER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 NW 70TH AVE
PLANTATION FL
33317-2911
US

IV. Provider business mailing address

5379 LYONS RD #112
COCONUT CREEK FL
33073-2810
US

V. Phone/Fax

Practice location:
  • Phone: 954-642-1224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3596
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA59777
License Number StateFL

VIII. Authorized Official

Name: DR. HOWARD ALLAN STOLLER
Title or Position: PRESIDENT
Credential: L.AC.
Phone: 954-478-1911