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General NPI Number Information
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NPI Number | 1962986471
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Entity Type | Individual
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Provider Name | CHRIS STANEK DPT
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Gender | Male
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 1661 RAINBOW DR
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City | CLEARWATER
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State | FL
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Zip | 33755-6438
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Country | US
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Telephone | 727-442-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 2212 PARKLAND LOOP S
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City | LAKELAND
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State | FL
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Zip | 33811-2027
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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 |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 34020
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License Number State | FL
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