MEDICARE: DR. ERIC JASON STELNICKI 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	208200000X	Plastic Surgery Physician	ME77501	FL
2	2086S0120X	Pediatric Surgery Physician	ME77501	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	:	1700866985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC JASON STELNICKI MD

Provider Business Mailing Address
First Line	:	100 SE 15TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-3908
Country	:	US
Telephone Number	:	954-983-1899
Fax Number	:	954-318-3215

Provider Business Practice Location Address
First Line	:	100 SE 15TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-3908
Country	:	US
Telephone Number	:	954-983-1899
Fax Number	:	954-318-3215

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	02/14/2020

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