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General NPI Number Information
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NPI Number | 1598286783
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Entity Type | Organization
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Legal Business Name | STABILIFE
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 10/24/2017
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Provider Practice Location Address
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Address Line | 2700 W ATLANTIC BLVD STE 267
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City | POMPANO BEACH
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State | FL
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Zip | 33069-5736
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Country | US
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Telephone | 754-205-2915
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Fax |
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Provider Business Mailing Address
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Address Line | 23 SE 22ND AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33062-5312
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Country | US
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Telephone | 954-592-9355
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRETT GOLDSTEIN
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Credential | D.C.
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Telephone | 954-592-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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