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General NPI Number Information
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NPI Number | 1407879752
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Entity Type | Individual
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Provider Name | SHELDON STALLER MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 04/19/2018
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Provider Practice Location Address
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Address Line | 150 NW 168TH ST STE 301
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33169-6051
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Country | US
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Telephone | 305-654-5440
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Fax | 305-654-5445
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Provider Business Mailing Address
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Address Line | 8750 NW 36TH ST STE 300
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City | DORAL
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State | FL
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Zip | 33178-2499
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Country | US
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Telephone | 305-262-1610
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Fax | 305-907-6099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME16525
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License Number State | FL
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