MEDICARE: AMOS W STOLL MD

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
1	207T00000X	Neurological Surgery Physician	ME37172	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457315327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMOS W STOLL MD

Provider Business Mailing Address
First Line	:	1700 NW 49TH ST STE 125
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3750
Country	:	US
Telephone Number	:	954-763-6655
Fax Number	:	954-763-6799

Provider Business Practice Location Address
First Line	:	1601 S ANDREWS AVE
Second Line	:	3RD FLOOR
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2509
Country	:	US
Telephone Number	:	954-763-6655
Fax Number	:	954-763-6799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	08/08/2019

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Directions to “ AMOS W STOLL MD” Practice Location

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