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General NPI Number Information
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NPI Number | 1730868233
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Entity Type | Organization
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Legal Business Name | STOTLANDMEDICAL
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Dates
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Enumeration Date | 07/13/2023
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 2637 E ATLANTIC BLVD # 46566
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City | POMPANO BEACH
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State | FL
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Zip | 33062-4939
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Country | US
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Telephone | 724-299-1220
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Fax |
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Provider Business Mailing Address
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Address Line | 2885 SANFORD AVE SW STE 46566
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City | GRANDVILLE
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State | MI
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Zip | 49418-1342
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MITCHELL STOTLAND
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Credential |
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Telephone | 724-299-1220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number |
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License Number State |
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