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NPI Code Detail

MEDICARE: DR. STEPHEN M STILLMAN PH.D.

MEDICARE: DR. STEPHEN M STILLMAN PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistPY3639FL

General Provider Information

NPI Number : 1326261124
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN M STILLMAN PH.D.
Provider Business Mailing Address
First Line : 7820 PETERS RD
Second Line : SUITE E-105
City : PLANTATION
State : FL
Zip : 33324-4019
Country : US
Telephone Number : 954-472-6800
Fax Number : 954-472-1176
Provider Business Practice Location Address
First Line : 7820 PETERS RD
Second Line : SUITE E-105
City : PLANTATION
State : FL
Zip : 33324-4019
Country : US
Telephone Number : 954-472-6800
Fax Number : 954-472-1176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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